On the seventh Day of Christmas Happy Medic gave to me…
7 OB’s Crownin’
and a British Medic dressed in green
It amazes me how many emergency responders are completely unraveled by the OB call. You do realize we are only a few generations removed from mothers routinely delivering at home?
Of course, the death during child birth rate was higher, but still.
We seem to take the most natural of processes and demand needles, oxygen, diesel and sirens be added to the mix.
OB calls are actually straight forward in nature and require very little training to do the one part folks are most worried about, delivery.
In fact, you should be worried about dealing with an overstressed mother who clearly didn’t plan on having her baby in your messy, dirty rig. Her position of comfort is going to be non-compliant with restraining her for your balls to the wall lights and sirens return to the hospital where a whole new set of folks will panic.
Have you ever transported directly to the OB ward? Often times I’d swear we were mere seconds from delivery and these nurses aren’t even rushing! Perhaps they know their trade and we should take a cue.
Crowning is obviously a clear sign of imminent delivery, but is te straight forward presentation we hope for. No one wants to arrive on scene at see what Nicholas Cage’s character in Bringing out the Dead saw, two arms and a leg sticking out. In those situations, yes, the diesel and sirens are needed, but if you have a low risk, healthy, on time crowning delivery, consider staying in the home. You can better control lighting, access, patient comfort and condition.
When junior arrives she’s going to be blue and cold. Wrapping her in that tiny blanket in the kit might work in sunny San Diego, but be sure to take advantage of natural body heat. By placing the child to breast you can activate natural placenta delivery and bleeding control, provide maternal bonding AND keep her warm. Place them skin to skin and then cover, this should occur immediately after or during your APGAR scoring.
I start at 10 and dock points instead of trying to add them up from zero.
And when I hear the bells ring for an imminent birth and I arrive to a 20 week gestation female still dressed and on the phone I take a deep breath realizing things might be fine. But on the note of 20 weeks, do you know the cut off for the definition of child vs fetus? Regardless of your religious or political beliefs certain laws exist to guide you in your treatment of premature births as opposed to spontaneous abortion.
Take a deep breath. Childbirth has been happening for a lot longer than we’ve been panicking about it and will continue without us.