Chapter 20
Chapter 20
Chapter 20
Cognitive Objectives (1 of 4)
4-9.1 Identify the following structures: uterus, vagina,
fetus, placenta, umbilical cord, amniotic sac,
perineum.
4-9.2 Identify and explain the use of the contents of
an obstetrics kit.
4-9.3 Identify predelivery emergencies.
4-9.4 State indications of an imminent delivery.
4-9.5 Differentiate the emergency medical care
provided to a patient with predelivery
emergencies from a normal delivery.
Cognitive Objectives (2 of 4)
4-9.6 State the steps in the predelivery preparation
of the mother.
4-9.7 Establish the relationship between body
substance isolation and childbirth.
4-9.8 State the steps to assist in the delivery.
4-9.9 Describe care of the baby as the head
appears.
4-9.10 Describe how and when to cut the umbilical
cord.
Cognitive Objectives (3 of 4)
4-9.11 Discuss the steps in the delivery of the
placenta.
4-9.12 List the steps in the emergency medical care
of the mother postdelivery.
4-9.13 Summarize neonatal resuscitation
procedures.
4-9.14 Describe the procedures for the following
abnormal deliveries: breech birth, prolapsed
cord, limb presentation.
Cognitive Objectives (4 of 4)
4-9.15 Differentiate the special considerations for
multiple births.
4-9.16 Describe special considerations of
meconium.
4-9.17 Describe special considerations of a
premature baby.
4-9.18 Discuss the emergency medical care of a
patient with a gynecological emergency.
Affective Objectives
4-9.19 Explain the rationale for understanding the
implications of treating two patients (mother
and baby).
Psychomotor Objectives (1 of 2)
4-9.20 Demonstrate the steps to assist in the normal
cephalic delivery.
4-9.21 Demonstrate necessary care procedures of
the fetus as the head appears.
4-9.22 Demonstrate infant neonatal procedures.
4-9.23 Demonstrate postdelivery care of infant.
4-9.24 Demonstrate how and when to cut the
umbilical cord.
4-9.25 Attend to the steps in the delivery of the
placenta.
Psychomotor Objectives (2 of 2)
4-9.26 Demonstrate the postdelivery care of the
mother.
4-9.27 Demonstrate the procedures for the following
abnormal deliveries: vaginal bleeding, breech
birth, prolapsed cord, limb presentation.
4-9.28 Demonstrate the steps in the emergency
medical care of the mother with excessive
bleeding.
4-9.29 Demonstrate completing a prehospital care
report for patients with
obstetrical/gynecological emergencies.
Female Reproductive System
Three Stages of Labor
• First stage
– Dilation of the cervix
• Second stage
– Expulsion of the infant
• Third stage
– Delivery of the placenta
Predelivery Emergencies
• Preeclampsia
– Headache, vision disturbance, edema, anxiety,
high blood pressure
• Eclampsia
– Convulsions resulting from hypertension
• Supine hypotensive syndrome
– Low blood pressure from lying supine
Hemorrhage
• Vaginal bleeding that occurs before
labor begins
• If present in early pregnancy, it may be
a spontaneous abortion or ectopic
pregnancy.
Ectopic Pregnancy
• Pregnancy outside of the uterus
• Should be considered for any woman of
childbearing age with unilateral lower abdominal
pain and missed menstrual period
• History of PID, tubal ligation, or previous ectopic
pregnancy
Placenta Problems
• Placenta abruptio • Placenta previa
– Premature separation – Development of
of the placenta placenta over the
cervix
Gestational Diabetes
• Develops only during pregnancy.
• Treat as regular patient with diabetes.
• You and your partner are dispatched to the A&E
Bank for a woman in active labor.
• En route, you discuss previous experiences
assisting in a delivery and how you can prepare
yourselves.
• What equipment should accompany you and your
partner inside the bank?
You are the Provider
• You find a woman in her mid 30s lying on the
couch, holding her abdomen and moaning.
• Between labored breaths she tells you that her
name is Jane and that she is a teller.
• She is conscious, alert, and oriented. Breathing in
rapid panting breaths. Pulse is strong and
bounding. Skin is pale and clammy.
• What questions might you consider asking to
assess how far along her labor is? You are the Provider
(continued)
Scene Size-up
restroom indicate?
Focused History and
Physical Exam