![]() Tailor ventilator support to oxygenation and ventilation Verify endotracheal tube with carbon dioxide detectorĮsophageal detector more likely not to reinflate after compression ![]() Start intravenous therapy above diaphragmĮarly tracheal intubation use short laryngoscope handle and smaller endotracheal tubeĭifficult ventilation with pharyngeal edema, breast hypertrophy, diaphragmatic elevationĬonsider other etiologies (e.g., magnesium toxicity)Ĭonsider left wide paddle, adhesive pad, or breast displacementĭextrorotation of the heart breast hypertrophy Heimlich maneuver use chest thrust if unable to encircle the gravid abdomen Loss of adequate cardiac shock dose produces skin burns at monitor sites Remove fetal and uterine monitors before defibrillation Perform compressions higher on the sternum (slightly above center of sternum) Use cricoid pressure, if assistance is available Perform manual uterine displacement, or 25- to 30-degree left lateral tiltĭecreased chest wall compliance with breast hypertrophy and diaphragmatic elevation All women of childbearing age should be routinely screened for intimate partner violence. The lap belt should be placed as low as possible under the protuberant portion of the abdomen and the shoulder belt positioned off to the side of the uterus, between the breasts and over the midportion of the clavicle. Proper seat belt use reduces the risk of maternal and fetal injuries in motor vehicle crashes. Unique aspects of advanced cardiac life support include early intubation, removal of all uterine and fetal monitors, and performance of perimortem cesarean delivery. To improve the effectiveness of cardiopulmonary resuscitation, clinicians should perform left lateral uterine displacement by tilting the whole maternal body 25 to 30 degrees. The Kleihauer-Betke test should be performed after major trauma to determine the degree of fetomaternal hemorrhage, regardless of Rh status. Ultrasonography has low sensitivity, but high specificity, for placental abruption. ![]() ![]() In minor trauma, four to 24 hours of tocodynamometric monitoring is recommended. Nine out of 10 traumatic injuries during pregnancy are classified as minor, yet 60% to 70% of fetal losses after trauma are a result of minor injuries. The most common traumatic injuries are motor vehicle crashes, assaults, falls, and intimate partner violence. Trauma complicates one in 12 pregnancies, and is the leading nonobstetric cause of death among pregnant women. ![]()
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