PRE-ECCLAMPSIA
DESIGNATION OF CONDITION
Pregnant patient complicated by hypertension and characterized by proteinuria, extremity edema, headache, visual disturbances, RUQ abdominal pain and may progress to ecclamptic seizures.
ALL LEVELS
1. Assess ABC’s and address as appropriate
2. Blood pressure >140/90 or 20 mmHg rise systolic or 10 mmHg diastolic over baseline
3. Keep patient in a left lateral decubitus position and keep away from intense stimulus (i.e. bright lights, loud noises, etc.). Headache, visual problems, abdominal pain or BP > 160/100 indicate more severe disease.
4. Administer OXYGEN titrated to patient condition.
5. Anticipate seizures.
6. Unless delivery is imminent, transport immediately.
7. Eclamptic seizures can occur up to 2 months post-partum
AEMT
1. Establish IV/IO
2. Consider ALS intercept
PARAMEDIC
1. If patient is symptomatic and SBP >170 mmHg or DBP >110 mmHg consider MAGNESIUM SULFATE 4 gm. IV/IO over 20 minutes.
2. If seizure occurs
a. MAGNESIUM SULFATE 4 gms slow IV/IO
b. MIDAZOLAM 0.2 mg./kg. up to 10 mg. IM is safe and effective route for seizures. 2-4 mg slow IV/IO/IN. Repeat as needed.
3. For Magnesium Sulfate toxicity, administer CALCIUM PREPERATION [5-10 ml] slow IV/IO. Do not exceed 2ml/min.
4. If patient has a seizure disorder initiate treatment with benzodiazepine initially. If eclamptic seizure suspected treat with magnesium.
DESIGNATION OF CONDITION
Pregnant patient complicated by hypertension and characterized by proteinuria, extremity edema, headache, visual disturbances, RUQ abdominal pain and may progress to ecclamptic seizures.
ALL LEVELS
1. Assess ABC’s and address as appropriate
2. Blood pressure >140/90 or 20 mmHg rise systolic or 10 mmHg diastolic over baseline
3. Keep patient in a left lateral decubitus position and keep away from intense stimulus (i.e. bright lights, loud noises, etc.). Headache, visual problems, abdominal pain or BP > 160/100 indicate more severe disease.
4. Administer OXYGEN titrated to patient condition.
5. Anticipate seizures.
6. Unless delivery is imminent, transport immediately.
7. Eclamptic seizures can occur up to 2 months post-partum
AEMT
1. Establish IV/IO
2. Consider ALS intercept
PARAMEDIC
1. If patient is symptomatic and SBP >170 mmHg or DBP >110 mmHg consider MAGNESIUM SULFATE 4 gm. IV/IO over 20 minutes.
2. If seizure occurs
a. MAGNESIUM SULFATE 4 gms slow IV/IO
b. MIDAZOLAM 0.2 mg./kg. up to 10 mg. IM is safe and effective route for seizures. 2-4 mg slow IV/IO/IN. Repeat as needed.
3. For Magnesium Sulfate toxicity, administer CALCIUM PREPERATION [5-10 ml] slow IV/IO. Do not exceed 2ml/min.
4. If patient has a seizure disorder initiate treatment with benzodiazepine initially. If eclamptic seizure suspected treat with magnesium.