emt-basic curriculum module 4

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State of WisconsinEMT-Basic: A Practice BasedApproach to EMS EducationIII.IV.D. Bulb syringeE. TowelsF. 2 x 10 gauze spongesG. Sterile glovesH. One baby blanketI. Sanitary napkinsJ. Plastic bagEmergency Medical Care - Predelivery EmergenciesA. Miscarriage - Spontaneous abortion - emergency medical care1. Size up2. Initial assessment3. History and physical exam4. Assess baseline vitals5. Treatment based on signs and symptoms6. Apply external vaginal pads7. Bring fetal tissues to hospital8. Support motherB. Seizure during pregnancy - emergency medical care1. Size up2. Initial assessment3. History and physical exam4. Assess baseline vitals5. Treatment based on signs and symptoms6. Transport on left sideC. Vaginal bleeding - late pregnancy vaginal bleeding, with or withoutpain. Emergency medical care:1. Size up2. Initial assessment3. History and physical exam4. Assess baseline vitals5. Treatment based on signs and symptoms6. Apply external vaginal pads7. TransportD. Trauma - emergency medical care - same as other trauma patients1. Size up2. Initial assessment3. History and physical exam4. Assess baseline vitals5. Treatment based on signs and symptoms6. Transport on left sideNormal DeliveryA. Predelivery considerations1. It is best to transport an expecting mother, unless delivery isexpected within a few minutes based on assessment of:a) Are you pregnant?b) How long have you been pregnant?Module 4-94
State of WisconsinEMT-Basic: A Practice BasedApproach to EMS Educationc) Are there contractions or pain?d) Any bleeding or discharge?e) Is crowning occurring with contractions?f) What is the frequency and duration of contractions?g) Does she feel as if she is having a bowel movement withincreasing pressure in the vaginal area?h) Does she feel the need to push?i) Rock hard abdomen?2. Precautionsa) Use body substance isolationb) Do not touch vaginal areas except during delivery andwhen your partner is presentc) Do not let the mother go to bathroomd) Do not hold mother's legs togethere) Recognize your own limitations and transport even ifdelivery must occur during transportf) If delivery is eminent with crowning, contact medicaldirection for decision to commit to delivery on site. Ifdelivery does not occur within 10 minutes, contactmedical direction for permission to transport.B. Delivery procedures1. Apply gloves, mask, gown, eye protection for infection controlprecautions2. Have mother lie with knees drawn up and spread apart3. Elevate buttocks - with blankets or pillow4. Create sterile field around vaginal opening with sterile towels orpaper barriers5. When the infant's head appears during crowning, place fingerson bony part of skull (not fontanelle or face) and exert verygentle pressure to prevent explosive delivery. Use caution toavoid fontanelle.6. If the amniotic sac does not break, or has not broken, use aclamp to puncture the sac and push it away from the infant'shead and mouth as they appear7. As the infant's head is being born, determine if the umbilicalcord is around the infant's neck; slip over the shoulder or clamp,cut and unwrap8. After the infant's head is born, support the head, suction themouth two or three times and the nostrils. Use caution to avoidcontact with the back of the mouth.9. As the torso and full body are born, support the infant with bothhands10. As the feet are born, grasp the feet11. Wipe blood and mucus from mouth and nose with sterile gauze,suction mouth and nose againModule 4-95
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