scenario question, placenta abruptia

[emt seeking first job]

I am reviewing my class notes.

Accorsding to NYC, NYS protocols, a patient with placentia abruptio is to be transported in a left lateral recumbant position to keep her off her vena cava.

Should this be the case for any other pregnant patient or any other patient.

Thank you in advance.

 

[Shishkabob]

Yes, it is typically a good idea to put preggos on their left side as the baby can push against the vena cava causing things such as syncope.

 

[lampnyter]

yes. pretty much always put the pregnant patient on their left side. if they need to be on a backboard, just tilt up the right side of it.

 

[MrBrown]

yes. pretty much always put the pregnant patient on their left side. if they need to be on a backboard, just tilt up the right side of it.

.... or get a guideline more advanced than about 1990 which does not require a backboard

 

[Sassafras]

Or if they are in active labor let them do their thing LOL. Ever try strapping a laboring woman to a gurney? It doesn't work too well. If they can sit up slightly we do that as well (barring issues requiring laying). But laboring we have allowed them to sit and strapped the chest allowed the abdominal belt to be loose and removed the feet straps so she can move to comfort level. Obviously all bets are off if I see limbs or cord, but until then keep em comfy and safe.

 

[lampnyter]

lol, were old school

 

[LucidResq]

Yes, it is typically a good idea to put preggos on their left side as the baby can push against the vena cava causing things such as syncope.

Linuss...seriously?! If I was pregnant and you referred to me as a "preggo" I would punch you.

 

[lampnyter]

Linuss...seriously?! If I was pregnant and you referred to me as a "preggo" I would punch you.

lol

 

[Sassafras]

Naw, not me. I referred to myself as the preggo heffalump often LOL.

 

[abckidsmom]

Also, some obese patients can have that hypotension from vena cava compression as well. Not nearly as commonly as with pregnant people.

 

[Sassafras]

Also, some obese patients can have that hypotension from vena cava compression as well. Not nearly as commonly as with pregnant people.

Really? Hmmm. You learn something new every day.

 

[jjesusfreak01]

Also, some obese patients can have that hypotension from vena cava compression as well. Not nearly as commonly as with pregnant people.

Probably something to keep to yourself when with the patient.

"Wow, it looks like your belly is compressing your vena cava. We normally only see that in pregnant women"

 

[ke5kce]

.... or get a guideline more advanced than about 1990 which does not require a backboard

If C-spine stabilization was required due to the situation/trauma, what kind of guideline would prevent the use of a backboard? None that I have ever seen or heard of

 

[LucidResq]

If C-spine stabilization was required due to the situation/trauma, what kind of guideline would prevent the use of a backboard? None that I have ever seen or heard of

Situation/MOI is one factor to consider when making the decision to board or not. If a patient is not complaining of any neck or back pain, there are no neural deficits (tingling, numbness, etc), no deformities, distracting injuries or drugs/EtOH or language barriers... there's probably no need for a backboard. Of course if the patient fell 70 feet or something... yeah you're probably going to board them. But in most situations that meet the criteria above, there's evidence that supports the board will cause more harm than good.

 

[aewin90]

My wife did the whole "left side only" thing for about two months before she became too uncomfortable from staying on the same side all the time. So she started sleeping on her right side as well.

And nothing happened.

Our OB confided later that complications from laying on one's right side are extremely rare and it's more of a CYA on the medical staff's part. Of course you want to be safe, but pregnant women have been sleeping on their right sides for tens of thousands of years.

But from an EMS point of view where you care for the patient for no more than an hour, just put them on their left side.

 

[CAOX3]

I don't know how it is in any other area but we haven't been basing treatment on MOI for ten years or so, its truly a poor indicator of potential injury.

I think its stone age to pull up to an MVA and base treatment on damage. People get enamored with what the vehicle looks like and want to fly helicopters and alert trauma teams without a thorough assessment.

As far as OB calls I'm not allowed if I get with in ten feet of a pregnant woman at least six months along them seem to want to deliver, so I kindly defer to another waiting ambulance.