13d • EMT Talk
OB Care you HAVE to know
Fertilization (High-Yield Foundation)
- Fertilization occurs in the fallopian tube
- The fertilized egg then travels to the uterus for implantation
NREMT takeaway: If implantation occurs outside the uterus → think ectopic pregnancy (life-threatening)
Abruptio Placentae (Placental Abruption)
What it is:
- Premature separation of the placenta from the uterine wall
Classic Signs & Symptoms (MEMORIZE)
- Painful vaginal bleeding
- Occurs >20 weeks gestation
- Dark red bleeding
- Abdominal pain / uterine tenderness
- Possible shock out of proportion to visible bleeding
Clinical Significance
- Decreased oxygen to fetus
- High risk of maternal hemorrhage and fetal demise
EMS Management
- High-flow oxygen
- IV access, fluid resuscitation
- Rapid transport
- Treat for shock
NREMT Pearl: Painful + dark blood = Abruptio placentae(Contrast: painless bleeding = placenta previa)
Stages of Labor
Stage 1 – Cervical Dilation
- Begins with contractions
- Ends when cervix is fully dilated (10 cm)
- Patient may have urge to push near the end
Stage 2 – Expulsion (Delivery of the Baby)
- Fully dilated cervix → pushing begins
- Ends with delivery of the newborn
Stage 3 – Placental Delivery
- Delivery of the placenta
- Usually occurs within minutes after birth
EMS Considerations
- Do NOT pull on the placenta
- Allow it to deliver naturally
- Monitor for bleeding
Breech Delivery (Critical Scenario)
What it is:
- Baby presents feet or buttocks first
High-Risk Complication:
- Body delivers, but head becomes trapped
What to do (NREMT CRITICAL STEP)
- Insert fingers to create a “V” airway to allow breathing
- Position mother knees-to-chest
- Rapid transport
What NOT to do:
- Do NOT pull the baby out
- Do NOT perform uterine massage to deliver the head
NREMT Pearl: Airway first → create space for breathing until head delivers
Umbilical Cord Presentation / Prolapse
What it is:
- Umbilical cord presents before the baby
Why it’s dangerous:
- Cord compression → loss of fetal oxygenation
What to do (HIGH-YIELD)
- Insert gloved hand into vagina
- Lift presenting part OFF the cord (decompress)
- Place patient in: Knee-chest OR Trendelenburg position
- Apply moist sterile dressing to exposed cord
- Rapid transport
What NOT to do:
- Do NOT push the cord back in
- Do NOT pull on the cord
- Do NOT ask mom to push
NREMT Pearl: Hand in vagina holding baby off cord = correct answer
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OB Care you HAVE to know
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