Trauma In Pregnancy Temple College EMS Professions

Trauma n Leading cause of death during pregnancy n MVAs cause 50% of prenatal mortality n Consider possible pregnancy in any female trauma patient of childbearing age

Trauma In Pregnancy n Priorities same as in non-pregnant patient n ABCs

Trauma In Pregnancy n Most common cause of fetal death from trauma is maternal death n Whats good for mom is good for baby!!

Alterations In Pregnancy n As pregnancy progresses: –Heart rate increases –Blood pressure decreases n Normal pregnant vital signs mimic hypoperfusion n Assessment more difficult

Alterations In Pregnancy n 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 n 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 n Uterus can compress inferior vena cava when patient is supine –Decreases cardiac output % –Do NOT put pregnant patients in supine position!

Management n Airway n C-spine control n High flow O 2 –3rd trimester O 2 demand increases 10-20% n Assist ventilation

Management n If MAST used, inflate legs only n Transport patient: –on left side, or –elevate right side of spine board