HomeMy WebLinkAboutSOG 203.01U Reviewed 5-2015 AD Emergency ChildbirthI. Goal
The goal of this policy is to define the standard of care for any patient presenting in labor
(abnormal delivery).
Protocol
A. All Deliveries
1. Mother:
a. Institute protocol "203.01A" for all patients.
b. Prepare for delivery by:
1) Placing another on a firm surface.
2) Opening & preparing OB Kit.
c. Prepare for delivery of placenta.
B, Premature Delivery
1, In ant:
a. Prepare for premature infant by preparing warming device.
b. Suction, dry, and stimulate infant.
c. CIamp & cut cord:
1) 1st clamp approximately six (6) inches from. baby.
2) 2nd clamp three (3) inches past the first.
3) Monitor for leaking.
d. Wrap infant, paying particular attention to the head.
e. Prepare for resuscitation, as needed:
1) HR < 60 = perform CPR
2) HR >60, but < 100 = Ventilate
3) HR > 100, but < 150 = `Blow by" Oxygen
f. Document time of delivery.
g. Record APGAR at one (1) and five (5) minutes.
n o 'se ts:
A •foush Kavaspour, MD
Medical Director BEMS/BFRS
L2
Date Signed
C. Nuchal Cord (Around Neek) Presentation
Mother & Infant:
a. Institute protocol "203.OIA" for all patients.
b. If cord is relatively loose, remove it from around infant's neck by
lifting it with finger.
c. If cord is not loose enough, clamp and cut cord.
d. Provide supportive care for baby, as needed.
D. Prolapsed Cord Presentation
1. Mother & Infant:
a. Institute protocol "203.01A" for all patients.
b. Position mother in lateral recumbent (knee -chest or "praying")
position.
c. Gather umbilical cord in gloved hand and re-insert it and gloved
hand into vagina.
d. Manually locate the infant's head.
e. Gently lift infant from contact with cord.
E. Limb Presentation
1. Mother & In fan_t:
a. Institute protocol "203.01A" for all patients.
b. Position mother in LEFT lateral recumbent (knee -chest or
"praying") position.
c. Prepare for rapid transport to a labor and delivery facility.
F. Breach Presentation
Mother & Infant:
�a. Institute protocol "203.01A" for all patients.
b. Deliver as normal.
c. If infant does not deliver within two (2) to three (3) minutes, insert
two (2) fingers into vagina over infant's face to provide an airway
for the infant.
Medical Director's Initials /3 , + 1
Date ! / S
SOG 203.010 - Emergency Childbirth (Abnormal Delivery) Page 2 of 2