Trauma In Pregnancy

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Section 7 - PEDIATRIC / OBSTETRICAL

7.12 Trauma in Pregnancy

INITIAL TRAUMA CARE PRACTICE PARAMETER (2.02) OXYGEN @ 100% via NRB mask or assist with BVM.


EMERGENCY C-SECTION

  • Maternal health and well being should not be compromised to save a fetus of any gestational age.
  • Emergency C-Section should only be considered when maternal death has verified and is determined to be irreversible
    • Trauma that cannot support life accompanied by a rhythm that cannot support life.
    • Trauma with ASYSTOLE (4.02) or No vitals with ASYSTOLE (4.02)
    • “Injuries and rhythm that is inconsistent with life.”
  • Fetus viability- 24 weeks gestational age or greater.
  • For optimal survival C-Section should be performed within 4 minutes of maternal death
  • Assess fetal heart tones if possible
  • Prepare Equipment- OB kit, trauma pads, and infant resuscitation equipment.
  • Locate anatomical landmarks for incision-Xiphoid Process and Pubis
  • Using a scalpel, perform vertical incision midline between-Xiphoid Process and Pubis
    • Cut through each layer of the abdominal wall with the scalpel and/or scissors.
    • Lift skin and pull apart working through the layers
    • Using the scalpel make initial incision in the uterus.
    • Using scissors cut the uterine wall.
    • Remove neonate,
    • Suction the neonate’s airway.
    • Double clamp the cord
    • Keep the infant lower than the mother.
    • Wait for the cord to stop pulsating,
    • Record APGAR at 1 and 5 minutes.
    • Transport to the appropriate facility.
Fundal Heights