CHILDBIRTH (IMMINENT DELIVERY)
ALL LEVELS
1. If the birth is imminent in the pre-hospital setting:
a. Reassure mother - encourage to not bear down between contractions, but to “pant”.
b. Place slight pressure over the head with hand to prevent rapid delivery, but do not attempt to delay delivery.
c. Once head delivers, instruct mother to stop pushing.
d. Support body as delivery proceeds. Baby will be extremely slippery. DO NOT pull on baby.
e. Suction airway with bulb suction.
f. Dry and wrap in blanket, cover head. Stimulate the baby to breathe/cry. If baby does not breathe spontaneously, continue stimulation efforts, apply oxygen and prepare to ventilate with BVM.
g. If bleeding occurs post-delivery, provide fundal massage to mother’s abdomen/uterus.
h. Do not wait on scene for placenta delivery. Do not pull on the umbilical cord (deliver birth products to ED).
i. Place sterile pad over vaginal opening.
j. Cover mother with clean and dry bedding.
k. Record time of the birth.
l. Do not let the neonate become hypothermic.
2. Transport mother and baby to the nearest hospital. Bring all blood-soaked pads and passed tissue to hospital.
3. Monitor the mother and baby’s vital signs and APGAR at 1, 5 and 10 minutes after delivery.
AEMT
1. If the mother continues to bleed, initiate an IV of LR and infuse at a flow rate to maintain adequate end organ perfusion.
PARAMEDIC
1. In all field deliveries administer OXYTOCIN (Pitocin) 10 mg. IM immediately after birth. (10mg./ml. concentration).
2. Consider TXA administration for severe post-partum bleeding.
ALL LEVELS
1. If the birth is imminent in the pre-hospital setting:
a. Reassure mother - encourage to not bear down between contractions, but to “pant”.
b. Place slight pressure over the head with hand to prevent rapid delivery, but do not attempt to delay delivery.
c. Once head delivers, instruct mother to stop pushing.
d. Support body as delivery proceeds. Baby will be extremely slippery. DO NOT pull on baby.
e. Suction airway with bulb suction.
f. Dry and wrap in blanket, cover head. Stimulate the baby to breathe/cry. If baby does not breathe spontaneously, continue stimulation efforts, apply oxygen and prepare to ventilate with BVM.
g. If bleeding occurs post-delivery, provide fundal massage to mother’s abdomen/uterus.
h. Do not wait on scene for placenta delivery. Do not pull on the umbilical cord (deliver birth products to ED).
i. Place sterile pad over vaginal opening.
j. Cover mother with clean and dry bedding.
k. Record time of the birth.
l. Do not let the neonate become hypothermic.
2. Transport mother and baby to the nearest hospital. Bring all blood-soaked pads and passed tissue to hospital.
3. Monitor the mother and baby’s vital signs and APGAR at 1, 5 and 10 minutes after delivery.
AEMT
1. If the mother continues to bleed, initiate an IV of LR and infuse at a flow rate to maintain adequate end organ perfusion.
PARAMEDIC
1. In all field deliveries administer OXYTOCIN (Pitocin) 10 mg. IM immediately after birth. (10mg./ml. concentration).
2. Consider TXA administration for severe post-partum bleeding.