Temple College EMS Professions 4/24/2017 Trauma In Pregnancy Temple College EMS Professions 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 Assist ventilation 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