EMT-Basic(Obsterics/Gynecology)
Terms
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- Important point to remember when suctioning the airway of a newborn with a bulb syringe.
- Squeeze the syringe BEFORE inserting the tip into the newborn's mouth or nose.
- Two ways a newborn may be stimulated to breathe.
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1. Flick the soles of the infant's feet.
2. Rub the infant's back.
NOTE: Infant's should start breathing on their own within 20-30 seconds after birth. If not or the rate is inadequate, start artificial ventilations. - When caring for a newborn, heart rate which indicates a need for artificial ventilation, and heart rate which indicates a need for ventilations and chest compressions.
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If Heart Rate Is Less Than 100:
Provide artificial ventilations at a rate of 60 per minute.
If Heart Rate Is Less Than 80 And Patient Is Not Responding To Ventilations:
Continue ventilations and start chest compressions at a rate of 120 per minute(2 compressions a second). - Position in which the newborn should be placed prior to cutting the cord.
- Keep the infant level with the mother's vagina and with it's head slightly lower than it's trunk.
- Proper spacing for cord clamps or ties.
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Place the first clamp FOUR finger widths away from the baby.
Place the second clamp several inches further away from the first clamp. - Normal amount of blood loss which may be expected following delivery.
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Up to 500ml.
NOTE: More than 500ml blood loss is considered excessive. Uterine Massage can help control bleeding after delivery. Massaging can be continued enroute to the hospital. - Primary problem associated with a meconium emergency.
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Severe Respiratory Problems:
The presence of meconium may be an indication of maternal or fetal distress during labor.
NOTE: Amniotic fluid which contains meconium is greenish or brownish-yellow in color. Aggressive management of the newborn's airway, including proper suctioning, is critical. - Proper position in which to place a pregnant patient with a prolapsed cord, breech presentation or limb presentation.
- Head down position with pelvis elevated. This will let gravity lessen the pressure in the birth canal.
- Two instance during delivery when an EMT-Basic may need to insert fingers into the patient's vagina.
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1. Breech Birth: To form an airway for the infant.
2. Prolapsed Cord: To take pressure off the cord. - Proper position in which to place a pregnant patient who has suffered traumatic injuries.
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Transport the patient on her left side.
NOTE: This position reduces the pressure which the fetus places on the mothers Vena Cava. The patient can be secured to a backboard prior to placing her on her left side. - Common cause of vaginal bleeding which occurs late during pregnancy.
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Late pregnancy vaginal bleeding normally indicates an emergency involving the placenta.
NOTE: Bleeding may or may not be accompanied by pain.