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Obstetrics and Gynecological Emergencies PowerPoint Presentation

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Description : Check out this medical presentation on Emergency Medical Services (EMS), which is titled "Obstetrics and Gynecological Emergencies", to know about Obstetrics and Gynecological Emergencies.

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Published on : Aug 10, 2021 | Views : 2869 | Downloads : 38

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Slide 1-

Obstetrics and Gynecological Emergencies Chapter 17
Slide 2-

Topic Overview Reproductive Anatomy Normal Delivery Care/Resuscitation of Newborn Abnormal deliveries Predelivery emergencies Gynecologic emergencies
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Slide 4-

Anatomy
Slide 5-

Childbirth Terms & Definitions Crowning When the presenting part of the baby first bulges from the vaginal opening Cephalic presentation - Head first Breech presentation Limb Frank
Slide 6-

LABOR First Stage Begins with regular contractions, then thinning and gradual dilation of the cervix and ends when the cervix if fully dilated Second Stage Begins when the baby’s head enters the birth canal until the baby is born Third Stage Following the birth of the baby until the placenta is delivered
Slide 7-

Your Role Materials Needed Need OB kit (if available) Gloves Towels and drapes 4 x 4s Bulb syringe Umbilical tape or clamps Scissors or scalpel for cutting the cord
Slide 8-

Childbirth A baby blanket Several sanitary napkins Plastic bag Standard BSI precautions
Slide 9-

Childbirth Delivery Kit
Slide 10-

Normal Delivery Transport Decision (911 Call) Based on evaluation Number of prior births Distance to hospital or birthing center Complications expected Delivery Precautions Use of BSI Keep mother out of bathroom Do not hold mother’s knees together
Slide 11-

Childbirth Evaluating the Mother Patient name, age Which pregnancy? Gravida, Para and AB How long in labor Ask the patient if she feels the need to move her bowels Check for Crowning** Time uterine contractions
Slide 12-

Childbirth Vital signs if time allows Remember if this first baby and crowing or urge to push is not present then transport can be effect DO NOT LET MOTHER GO TO THE BATHROOM
Slide 13-

Childbirth Preparing for Delivery Control the scene BSI Position the patient Remove clothing that can obstruct view of delivery Create a sterile field Position OB kit or available materials
Slide 14-

Childbirth The Delivery
Slide 15-

Crowning of Infant’s Head
Slide 16-

Delivery of Head - Prevent Explosive Delivery
Slide 17-

Delivery of the Head
Slide 18-

Delivery Procedures If amniotic sac has not broken, puncture sac and pull away from baby's face. Determine if umbilical cord is around baby’s neck. If so, clamp and cut cord.
Slide 19-

Suction mouth, then nose Aid in birth of upper shoulder
Slide 20-

Support the trunk Support the legs
Slide 21-

Childbirth Delivery Procedures Wipe blood, mucus from nose and mouth Suction Warmth is critical! Wrap baby in warm towel, head lower than trunk Keep infant level with vagina until cord is cut
Slide 22-

Clamp or tie cord; then cut Evaluate baby
Slide 23-

Observe for delivery of placenta When placneta delivers, place in a plastic bag for transport to hospital
Slide 24-

Childbirth After Delivery Procedures Control vaginal bleeding after delivery DO PLACE ANYTHING IN THE VAGINA Place a sanitary napkin over the vaginal opening Have mother lower her legs **Massage the fundus **Nursing the baby can help the uterus contract and return to normal Record time of delivery
Slide 25-

Childbirth Vaginal Bleeding A loss of 55 cc is well tolerated. Treat for shock
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Slide 27-

Care of Newborn Position, dry, wipe, wrap Repeat clearing airway (suction) Cover the head
Slide 28-

Normal Assessment Findings Newborn Appearance Pulse Grimace Activity Respiratory effort = = = = = A P G A R Color: No central cyanosis Greater than 100/min. Vigorous & crying Good extremity motion Normal, crying
Slide 29-

Childbirth
Slide 30-

Resuscitation of the Newborn
Slide 31-

Inverted Pyramid of Neonatal Resuscitation
Slide 32-

Breathing Effort If shallow, slow, or absent: Provide artificial ventilations, 40-60/minute. Reassess after 30 seconds. Continue as necessary.
Slide 33-

Heart Rate If less than 100/minute: Provide artificial ventilations, 40-60/minute. Reassess after 30 seconds. If no improvement, continue ventilations. (Continued)
Slide 34-

Heart Rate If less than 60-80/minute and not responding to ventilation: Start chest compressions. (Continued)
Slide 35-

Heart Rate If at any time the heart rate is less than 60, begin ventilations and compressions immediately.
Slide 36-

Color If central (trunk) cyanosis is present with adequate breathing and heart rate, administer blow-by oxygen.
Slide 37-

Childbirth Complications / Abnormal Deliveries
Slide 38-

Complications Supine Hypotensive Syndrome The weight of the baby, placenta and amniotic fluid can compress the vena cava Care Place mother on lateral left side
Slide 39-

Complications Breach Birth Baby’s buttocks or lower extremities presenting Greater risk of trauma, prolapsed cord Care Never pull on the babies legs High flow oxygen Place mother in head-down position with hips elevated
Slide 40-

Complications If body delivers support the body and prevent an explosive delivery of the head If necessary to create an airway, place two fingers of gloved hand into vagina making a “V” with your fingers to create an airway. Hope position until EMS arrives or baby delivers
Slide 41-

Complications Prolapsed Umbilical Cord Mother in head down and buttocks up (kneeling with buttocks up) High flow oxygen Check cord for a pulse Wrap the cord in a towel to keep warm Insert gloved fingers in the vaginal and pressure gently on the babies head or buttocks to take pressure off the cord
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Slide 44-

Complications Limb Presentation High flow oxygen Do Not pull on the baby
Slide 45-

Complications Multiple Births Delivery procedures the same for each birth Prepare for multiple resuscitations Clamp the cord of the first baby 2nd baby may be born before or after the placenta Care for first infant Maintain body temperature of the infants
Slide 46-

Complications Premature Birth Keep baby WARM Keep airway clear Provide ventilation (BVM) and chest compressions as needed Watch the umbilical cord for bleeding Oxygen using blow by method Avoid contamination, Do Not breath into the face of the baby
Slide 47-

Complications Pre-birth bleeding If you have any pre-birth bleeding place a pad at the opening of the vagina Save any tissue which is passed Meconium Green or brown amniotic fluid indicates presence of fecal matter Suggests fetal distress during labor
Slide 48-

Complications Pre-Eclampsia High blood pressure and swelling of the extremities The pregnant female needs to be monitored closely Eclampsia Seizures during pregnancy Seizures are a dire emergency Mother should be transported by EMS Administer high-flow oxygen
Slide 49-

Complications Fetal tissue goes to hospital Provide emotional support for mother
Slide 50-

Complications Miscarriage (Spontaneous Abortion) Complete patient assessment treatment based on assessment 911 (Save all tissue expelled) Vital Signs Treat for shock Place a napkin over the vaginal opening Replace all blood soaked pads and keep Emotional support for the patient
Slide 51-

Obstetrics and Gynecological Emergencies Trauma In Pregnancy- Patient Assessment Pulse will be 10-15 beats higher A pregnant female has 30-35% more blood so signs of shock will be delayed Ask patient about any blows to the back, pelvis or abdomen Ask if the patient is bleeding or has any discharge (water has broken)
Slide 52-

Obstetrics and Gynecological Emergencies Treatment for Pregnant Trauma Patient High flow oxygen Be ready to suction due due to nausea and possible vomiting Activate EMS Provide emotional support
Slide 53-

Gynecological Emergencies
Slide 54-

Gynecological Emergencies Vaginal Bleeding Can be potentially life-threatening Follow BSI precautions Assure airway Assess and treat for shock Provide oxygen Activate EMS if bleeding is severe
Slide 55-

Gynecological Emergencies Trauma to the External Genitalia Scene size up and look at the mechanism of injury During initial assessment look for signs of shock Treat like any soft-tissue injury Control bleeding with direct pressure Never pack vagina If signs of shock high flow O2
Slide 56-

Gynecological Emergencies Sexual Assault Treat scene as a crime scene Complete patient assessment and care Take care not to destroy evidence on the scene Activate EMS Provide comfort for the patient Non-judgemental attitude Psychological care required
Slide 57-

Gynecological Emergencies Sexual Assault Preserve potential evidence Discourage patient from bathing, voiding
Slide 58-

Review Questions Describe the anatomy of the reproductive system List the items you will need in a childbirth kit What factors will determine whether 911 should transport or deliver at scene
Slide 59-

Review Questions Describe the normal delivery process Describe the APGAR scoring system Describe the following, and the care for each: Limb presentation Prolapsed cord Breech presentation Meconium