First Responder EMS Curriculum for Training Centers in Eurasia

Skill Descriptions: Children and ChildbirthNote: All skills assume proper precautions are already taken, includinggloves and face mask if appropriate.1. Techniques for Determining if Delivery is Imminenta. Questions1. What is your due date?2. Any chance of multiple births?3. Any bleeding or discharge?4. Do you feel as if you are having a bowel movement with increasing pressure in thevaginal area?5. Examine for crowning if the patient answers yes to the preceding questions.b. If crowning is present, prepare for delivery.1. Use body substance isolation.2. Do not touch vaginal areas except during delivery and when your partner is present.3. Do not let the mother go to bathroom.4. Do not hold mother's legs together.c. If the head is not the presenting part this may be a complicated delivery.1. Tell the mother not to push.2. Update responding emergency medical services (EMS) resources.3. Calm and reassure the mother.2. Technique for Delivering a Baby1. Ensure body substance isolation.2. Have mother lie on her back with knees drawn up and legs spread apart.3. Place absorbent, clean materials (sheets, towels, etc.) under the patient's buttocks.4. Elevate buttocks with blankets or pillow.5. When the infant's head appears, place the palm of your hand on top of the deliveringbaby's head and exert very gentle pressure to prevent explosive delivery.6. If the amniotic sac does not break or has not broken, tear it with your fingers andpush it away from the infant's head and mouth.7. As the infant's head is being born, determine if the umbilical cord is around theinfant's neck.• Attempt to slip the cord over the baby's shoulder.• If unsuccessful, attempt to alleviate pressure on the cord.8. After the infant's head is born, support the head.9. Suction the mouth and then the nostrils two or three times with a bulb syringe.• Use caution to avoid contact with the back of the baby's mouth.• If a bulb syringe is not available, wipe the baby's mouth and then the nose withgauze.10. As the torso and full body are born, support the infant with both hands.11. Do not pull on the infant.First Responder EMS Curriculum/AIHA, July 2002 287