# Umbilical Cord



## Charity (Feb 9, 2016)

Not sure if this is the best forum section for this, so please feel free to move it, but I have a question about emergency childbirth. A lot of mothers and doctors think there are benefits to not instantly clamping and cutting the umbilical cord. I haven't done enough research on the issue to have an informed perspective, but I was wondering what the protocol for EMTs is? How soon after birth do they clamp/cut if the birth is say, in the back of the ambulance? If the mother requests for them to wait 5-10 minutes, do they have a legal obligation to follow her requests? Again, I'm not sure what my position is at this point, but it's an issue I'm curious on!


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## DesertMedic66 (Feb 9, 2016)

The pretty standard thing is to wait for the cord to pulsate before you clamp and cut it.


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## Charity (Feb 9, 2016)

DesertMedic66 said:


> The pretty standard thing is to wait for the cord to pulsate before you clamp and cut it.


 Hm, do you wait for it to start pulsating or stop pulsating?


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## DesertMedic66 (Feb 9, 2016)

Charity said:


> Hm, do you wait for it to start pulsating or stop pulsating?


My apologies. I meant to say stop pulsating


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## CANMAN (Feb 13, 2016)

DesertMedic66 said:


> My apologies. I meant to say stop pulsating



This, although with delayed cord clamping you may still feel a little pulsatile flow from mom, even if baby transitions to extrauterine life appropriately.... A lot of the new information you are speaking about in the research is preliminary at best right now in the neonatal world. By "delayed clamping" they are often talking about only 2-3 minutes, instead of immediate clamping. Delayed clamping has show some early benefits in increased iron storage and hemoglobin levels, but also suggests a slight risk increase for jaundice. We are evaluating some of this stuff at the Children's Hospital I work at, where they will typically delivery high risk Neonates in hospital for immediate placement into the NICU, thus eliminating the need for a NICU IFT transport. 

Remember when cutting, don't hack the thing off at the base  NICU guys like myself might need that stump to place UVC/UAC lines if the infant isn't doing so great post delivery.


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## Ewok Jerky (Feb 13, 2016)

Beware the hyperbillirubinemia


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## SpecialK (Feb 15, 2016)

Charity said:


> I have a question about emergency childbirth. !



I know you weren't asking about it per se but I feel it's worthy of noting normal vaginal birth is *not *an emergency.

Emergency childbirth would be something like severe ante-partum haemorrhage, nuchal cord, placentae previa, limb presentation, or maybe a retained placenta > 30 minutes.  In these cases, it is prudent to get mum to a hospital capable of obstetric surgery without significant delay, and to inform them of same as not all hospitals have on-site O&G, anaesthesia or ICU cover 24 hours per day.


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## wxemt (Mar 1, 2016)

My protocol is wait for it to stop pulsating, then clamp at 6 and 8 inches.


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## Martyn (Mar 7, 2016)

wxemt said:


> My protocol is wait for it to stop pulsating, then clamp at 6 and 8 inches.



Check your protocol then...it won't stop pulsating until AFTER it is clamped!!!!


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