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Referencing the content of EMT-Basic training and emergency patient care

EMT Basic · Chapter 34

Obstetrics and Neonatal Care

Learning objectives (22)

  1. Demonstrate how to assist in delivery of the placenta — Knowledge/skills objective (printed page 1243); confirm wording in your course copy.
  2. Demonstrate how to clamp and cut the umbilical cord — Knowledge/skills objective (printed page 1243); confirm wording in your course copy.
  3. Demonstrate procedures to follow for compli- cated delivery emergencies including vaginal bleeding, breech presentation, limb presentation, and prolapsed umbilical cord — Knowledge/skills objective (printed page 1243); confirm wording in your course copy.
  4. Demonstrate the postdelivery care of the woman — Knowledge/skills objective (printed page 1243); confirm wording in your course copy.
  5. Demonstrate the steps to follow in postdelivery care of the newborn — Knowledge/skills objective (printed page 1243); confirm wording in your course copy.
  6. Describe delivery of the placenta — Knowledge/skills objective (printed page 1243); confirm wording in your course copy.
  7. Describe postpartum complications and how to treat them — Knowledge/skills objective (printed page 1243); confirm wording in your course copy.
  8. Describe the indications of an imminent delivery — Knowledge/skills objective (printed page 1243); confirm wording in your course copy.
  9. Describe the procedure followed to clamp and cut the umbilical cord — Knowledge/skills objective (printed page 1243); confirm wording in your course copy.
  10. Differentiate among the three stages of labor — Knowledge/skills objective (printed page 1243); confirm wording in your course copy.
  11. Discuss special considerations involving pregnancy in different cultures and with teenage patients — Knowledge/skills objective (printed page 1243); confirm wording in your course copy.
  12. Discuss the need to consider two patients—the woman and the unborn fetus—when treating a pregnant trauma patient — Knowledge/skills objective (printed page 1243); confirm wording in your course copy.
  13. Explain assessment of the pregnant patient — Knowledge/skills objective (printed page 1243); confirm wording in your course copy.
  14. Explain the necessary care of the fetus as the head appears — Knowledge/skills objective (printed page 1243); confirm wording in your course copy.
  15. Explain the normal changes that occur in the body during pregnancy — Knowledge/skills objective (printed page 1243); confirm wording in your course copy.
  16. Explain the significance of meconium in the amniotic fluid — Knowledge/skills objective (printed page 1243); confirm wording in your course copy.
  17. Explain the steps involved in normal delivery management — Knowledge/skills objective (printed page 1243); confirm wording in your course copy.
  18. Explain the steps to take in neonatal assessment and resuscitation — Knowledge/skills objective (printed page 1243); confirm wording in your course copy.
  19. Identify the anatomy and physiology of the female reproductive system — Knowledge/skills objective (printed page 1243); confirm wording in your course copy.
  20. List the contents of an obstetrics kit — Knowledge/skills objective (printed page 1243); confirm wording in your course copy.
  21. Recognize complicated delivery emergencies, including breech presentations, limb presenta- tions, umbilical cord prolapse, spina bifida, mul- tiple gestation, premature newborns, p — Knowledge/skills objective (printed page 1243); confirm wording in your course copy.
  22. Recognize complications of pregnancy including abuse, substance abuse, hypertensive disorders, bleeding, spontaneous abortion (miscarriage), and gestational diabetes — Knowledge/skills objective (printed page 1243); confirm wording in your course copy.

Vocabulary (15)

Gravida
The total number of pregnancies a person has had, regardless of outcome.
Para
The number of pregnancies that have reached at least 20 weeks of gestation (regardless of live birth).
Trimester
One of three ~13-week segments of pregnancy used to describe fetal development and maternal changes.
Placenta
The organ that develops in pregnancy to provide oxygen and nutrients to the fetus and remove waste; delivered after the baby.
Umbilical cord
The flexible structure connecting the fetus to the placenta, containing two arteries and one vein.
Amniotic sac
The membranous sac filled with amniotic fluid surrounding the fetus during pregnancy.
Crowning
Appearance of the fetal head at the vaginal opening, signaling delivery is imminent.
APGAR score
A neonatal assessment at 1 and 5 minutes after birth — Appearance, Pulse, Grimace, Activity, Respiration; each scored 0–2 for a maximum of 10.
Preeclampsia
Pregnancy-related hypertension with proteinuria or end-organ involvement, typically after 20 weeks' gestation.
Eclampsia
New-onset seizures in a pregnant or postpartum person with preeclampsia, in the absence of another cause.
Placenta previa
Placenta partially or completely covering the cervical opening; presents as painless bright-red vaginal bleeding.
Placental abruption
Premature separation of the placenta from the uterine wall; presents with painful vaginal bleeding and a firm, tender uterus.
Breech presentation
Fetal position in which the buttocks or feet, rather than the head, present first at delivery.
Prolapsed cord
Umbilical cord protruding through the cervix ahead of the fetus, compressing the cord and threatening fetal oxygen supply.
Postpartum hemorrhage
Blood loss greater than 500 mL after vaginal delivery or 1,000 mL after cesarean, or any volume causing instability.

Sequence practice (2 puzzles on Quiz Me)

Assisting a normal field delivery

Order EMT steps for assisting a vertex delivery in the field.

  1. Position the patient with hips elevated; prepare OB kit; don PPE
  2. Support the fetal head as it emerges
  3. Check for the cord around the neck; if loose, slip over the head
  4. Suction the mouth then the nose only if there is obstructive secretions or meconium per current protocol
  5. Deliver the anterior shoulder, then the posterior shoulder, then the rest of the body
  6. Dry, warm, and stimulate the newborn; assess breathing and heart rate
  7. Clamp the cord in two places and cut between the clamps after pulsation slows
  8. Allow placenta to deliver; transport mother and infant
APGAR components in order

Order the five components of the APGAR mnemonic.

  1. A — Appearance (color)
  2. P — Pulse (heart rate)
  3. G — Grimace (reflex irritability)
  4. A — Activity (muscle tone)
  5. R — Respiration (respiratory effort)

Quick fire sample (15 of 15 on Quiz Me)

The total number of pregnancies a person has had, regardless of outcome.
  1. APGAR score
  2. Postpartum hemorrhage
  3. Breech presentation
  4. Gravida
The number of pregnancies that have reached at least 20 weeks of gestation (regardless of live birth).
  1. Para
  2. Gravida
  3. Trimester
  4. APGAR score
One of three ~13-week segments of pregnancy used to describe fetal development and maternal changes.
  1. Preeclampsia
  2. Breech presentation
  3. Prolapsed cord
  4. Trimester
The organ that develops in pregnancy to provide oxygen and nutrients to the fetus and remove waste; delivered after the baby.
  1. Placenta
  2. Trimester
  3. APGAR score
  4. Placenta previa
The flexible structure connecting the fetus to the placenta, containing two arteries and one vein.
  1. Para
  2. Postpartum hemorrhage
  3. Amniotic sac
  4. Umbilical cord
The membranous sac filled with amniotic fluid surrounding the fetus during pregnancy.
  1. APGAR score
  2. Umbilical cord
  3. Amniotic sac
  4. Eclampsia
Appearance of the fetal head at the vaginal opening, signaling delivery is imminent.
  1. Crowning
  2. Placental abruption
  3. Trimester
  4. Para
A neonatal assessment at 1 and 5 minutes after birth — Appearance, Pulse, Grimace, Activity, Respiration; each scored 0–2 for a maximum of 10.
  1. Gravida
  2. Preeclampsia
  3. Breech presentation
  4. APGAR score
Pregnancy-related hypertension with proteinuria or end-organ involvement, typically after 20 weeks' gestation.
  1. Para
  2. Placental abruption
  3. Trimester
  4. Preeclampsia
New-onset seizures in a pregnant or postpartum person with preeclampsia, in the absence of another cause.
  1. APGAR score
  2. Eclampsia
  3. Amniotic sac
  4. Para
Placenta partially or completely covering the cervical opening; presents as painless bright-red vaginal bleeding.
  1. Amniotic sac
  2. Crowning
  3. Para
  4. Placenta previa
Premature separation of the placenta from the uterine wall; presents with painful vaginal bleeding and a firm, tender uterus.
  1. Placental abruption
  2. Para
  3. Preeclampsia
  4. Placenta previa
Fetal position in which the buttocks or feet, rather than the head, present first at delivery.
  1. Breech presentation
  2. Prolapsed cord
  3. Eclampsia
  4. Crowning
Umbilical cord protruding through the cervix ahead of the fetus, compressing the cord and threatening fetal oxygen supply.
  1. Breech presentation
  2. Placenta previa
  3. Eclampsia
  4. Prolapsed cord
Blood loss greater than 500 mL after vaginal delivery or 1,000 mL after cesarean, or any volume causing instability.
  1. Postpartum hemorrhage
  2. Umbilical cord
  3. Para
  4. Preeclampsia

Some topics in this course differ across field references. See when sources disagree on Quiz Me before you teach from this sheet alone.

Full scored drills are on Quiz Me at /courses/nm-emt-b/chapters/34/print/. Answers are not marked on this sheet.