Trauma In Pregnancy
Temple College EMS Professions
Trauma
Leading cause of death during pregnancy MVA’s cause 50% of prenatal mortality Consider possible pregnancy in any female trauma patient of childbearing age
Trauma In Pregnancy
Priorities same as in non-pregnant patient ABC’s
Trauma In Pregnancy
Most common cause of fetal death from trauma is maternal death What’s good for mom is good for baby!!
Alterations In Pregnancy
As pregnancy progresses:
– Heart rate increases – Blood pressure decreases
Normal pregnant vital signs mimic hypoperfusion Assessment more difficult
Alterations In Pregnancy
Blood volume increases by 40-50%
– 30% blood loss may occur before shock signs and symptoms develop – Reversal of hypoperfusion more difficult
Alterations In Pregnancy
Blood flow to uterus, placenta can be selectively reduced
– Fetus can be in distress while mother appears stable – Adequate resuscitation of mom does NOT ensure adequate resuscitation of baby
Alterations In Pregnancy
Uterus can compress inferior vena cava when patient is supine
– Decreases cardiac output 30 - 40% – Do NOT put pregnant patients in supine position!
Management
Airway C-spine control High flow O2
– 3rd trimester O2 demand increases 10-20%
Assist ventilation
Management
If MAST used, inflate legs only Transport patient:
– on left side, or – elevate right side of spine board