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Questions and Answers
What is the leading indirect cause of maternal death in the UK?
What is the leading indirect cause of maternal death in the UK?
Most maternal deaths in the UK occur more than 42 days after childbirth.
Most maternal deaths in the UK occur more than 42 days after childbirth.
False
What anatomical change occurs at > 20 weeks of gestation that affects blood circulation?
What anatomical change occurs at > 20 weeks of gestation that affects blood circulation?
Compression of the inferior vena cava
What is the priority action if a pregnant woman is exhibiting signs of shock?
What is the priority action if a pregnant woman is exhibiting signs of shock?
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A woman who is more than 20 weeks pregnant should be transported in a supine position if compromised.
A woman who is more than 20 weeks pregnant should be transported in a supine position if compromised.
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Maternal blood volume increases by ______ percent during pregnancy.
Maternal blood volume increases by ______ percent during pregnancy.
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What should be examined for external injuries during the assessment?
What should be examined for external injuries during the assessment?
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Match the maternal physiological changes with their effects:
Match the maternal physiological changes with their effects:
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The woman should be tilted to the patient's ______ on the long board when fully immobilised.
The woman should be tilted to the patient's ______ on the long board when fully immobilised.
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What is a common reason that signs of shock may be slow to appear in pregnant patients?
What is a common reason that signs of shock may be slow to appear in pregnant patients?
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It is safe to use NEWS2 for assessing maternity patients.
It is safe to use NEWS2 for assessing maternity patients.
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Match the following actions with their correct descriptions:
Match the following actions with their correct descriptions:
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What should be included in the additional history required for a pregnant patient?
What should be included in the additional history required for a pregnant patient?
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List two 'red flags' during the primary survey of a pregnant trauma patient.
List two 'red flags' during the primary survey of a pregnant trauma patient.
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It is advisable to wait for assistance before transferring a pregnant woman showing signs of shock.
It is advisable to wait for assistance before transferring a pregnant woman showing signs of shock.
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What should be monitored during the assessment?
What should be monitored during the assessment?
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What is the primary aim of the management strategies for pregnant patients experiencing cardiac arrest?
What is the primary aim of the management strategies for pregnant patients experiencing cardiac arrest?
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Hypovolaemia is a common reason for maternal cardiac arrest.
Hypovolaemia is a common reason for maternal cardiac arrest.
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What does SBAR stand for in the context of communication in urgent medical situations?
What does SBAR stand for in the context of communication in urgent medical situations?
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A maternal trauma and cardiac arrest requires an urgent ______ to allow for a rapid review.
A maternal trauma and cardiac arrest requires an urgent ______ to allow for a rapid review.
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Match the following medical conditions with their characteristics:
Match the following medical conditions with their characteristics:
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Which of the following is NOT a method of management for pregnant patients during a crisis?
Which of the following is NOT a method of management for pregnant patients during a crisis?
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Maternal patients do not exhibit changes in physiology during pregnancy that may indicate distress.
Maternal patients do not exhibit changes in physiology during pregnancy that may indicate distress.
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What should be done when additional resources are delayed during a maternal emergency?
What should be done when additional resources are delayed during a maternal emergency?
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Study Notes
Maternal Trauma and Cardiac Arrest Overview
- Cardiac disease is the leading indirect cause of maternal death in the UK, exacerbated by pregnancy.
- Trauma accounts for 5% of maternal deaths, with most fatalities occurring within 42 days post-natal.
- Maternal mortality rate in London is double the national average.
Maternal Considerations in Trauma
- Uterine compression of the inferior vena cava is a risk after 20 weeks gestation; manual uterine displacement is necessary.
- Signs of shock may not appear until over 35% blood volume is lost.
- High risk of placental abruption, which can manifest 3-4 days post-incident.
- Domestic or sexual abuse must be considered and safeguarded against.
Maternal Physiology Changes
- Blood volume and cardiac output increase by 50% during pregnancy.
- Blood pressure decreases by approximately 10mmHg.
- The expanding uterus can compress major blood vessels, causing vascular and airway complications.
Assessment and Management
- NEWS2 is not validated for maternity patients; they often compensate well until later stages of deterioration.
- A lower threshold for transport applies compared to non-pregnant patients.
- Red flags include increased respiratory rate (>21), increased heart rate (>110), abdominal pain, vaginal bleeding, reduced fetal movements, and hypotension (last vital sign change).
Management Protocols
- Follow DR CAcBCDE protocol and ensure relevant PPE is worn.
- Consider advanced paramedic assistance if needed; assess the mechanism of injury (MOI) and consent.
- Examine for external injuries, administer oxygen, monitor vital signs, and apply dressings as appropriate.
- Ensure analgesia is provided (e.g., Entonox) and transport to an appropriate hospital using maternity assessment resources.
Optimisation Techniques
- Pregnant individuals over 20 weeks should be positioned laterally during transport to avoid major vessels’ compression.
- If unconscious, manually displace the uterus to the left side, requiring maintenance and documentation in ePCR.
Advanced Clinical Interventions
- Signs of shock necessitate immediate activation of advanced clinical help; do not delay on scene.
- Common causes of maternal cardiac arrest include heart failure, hypovolaemia, anaphylaxis, embolism, and sepsis.
Communication Protocol for Emergency Situations
- Use SBAR protocol for effective handover:
- Situation: Introduce self, role, and concerns.
- Background: Summarize relevant history and risk status.
- Assessment: Provide A-G assessment findings.
- Recommendation: Clearly state specific needs.
Summary Highlights
- Maternal physiology changes require vigilant monitoring; signs of decompensation may appear late.
- Recognize the implications of pregnancy on assessment and management strategies.
- Always prioritize safeguarding measures if abuse is suspected.
- Engage additional resources promptly, balancing risks without waiting unnecessarily on scene.
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Description
This quiz focuses on the anatomy, physiology, and assessment strategies for managing maternity patients, especially those who have experienced trauma and cardiac arrest. It covers key modifications and responsibilities necessary for effective care in these critical situations. Ideal for healthcare professionals dealing with emergency maternal care.
