EMERGENCY MEDICAL TECHNICIAN Review – 1 st half Compiled by Barry Barkinsky EMS-I

EMERGENCY EMERGENCY MEDICAL MEDICAL

TECHNICIANTECHNICIANReview – 1Review – 1stst half half

Compiled by Barry Barkinsky Compiled by Barry Barkinsky EMS-IEMS-I

PreparatoryPreparatory

The EMS The EMS SystemSystemComponents of theComponents of the

Emergency MedicalEmergency Medical

Services (EMS) SystemServices (EMS) System

Enhanced 911Enhanced 911

911911

Non-911Non-911

System AccessSystem Access

BystandersBystanders

Emergency Medical DispatcherEmergency Medical Dispatcher

First RespondersFirst Responders

Emergency Medical Technician-BasicEmergency Medical Technician-Basic

Advanced Life Support (ALS)Advanced Life Support (ALS)

Emergency Department StaffEmergency Department Staff

Trauma CentersTrauma Centers Burn CentersBurn Centers Pediatric CentersPediatric Centers Poison Control CentersPoison Control Centers

Specialty FacilitiesSpecialty Facilities

Roles and Roles and ResponsibilitiesResponsibilities

Scene SafetyScene Safety Patient Assessment / CarePatient Assessment / Care Lifting and MovingLifting and Moving Transport / Transfer of CareTransport / Transfer of Care DocumentationDocumentation Patient AdvocacyPatient Advocacy

Quality ImprovementQuality Improvement

Provides documentationProvides documentation Reviews & audits runsReviews & audits runs Gathers feedback from patients & Gathers feedback from patients &

hospital staffhospital staff Conducts preventive maintenance Conducts preventive maintenance Continues educationContinues education Maintains skillsMaintains skills

Medical DirectionMedical Direction

Medical DirectorMedical Director Sponsor HospitalSponsor Hospital Medical DirectionMedical Direction

On-Line – radio, phone patchOn-Line – radio, phone patch Off-Line – standing ordersOff-Line – standing orders

Well - BeingWell - Being

Well Being of the EMTWell Being of the EMT

Emotion and StressEmotion and Stress Scene safetyScene safety Exposure Control PlanExposure Control Plan Lifting and MovingLifting and Moving

Emotion and StressEmotion and Stress CausesCauses Signs and SymptomsSigns and Symptoms Dealing with StressDealing with Stress CISDCISD Understanding of Death and DyingUnderstanding of Death and Dying

Scene SafetyScene Safety

Scene safety starts on arrival and continues throughout the call!

Medical / LegalMedical / Legal

What is …?


Scope of Scope of PracticePractice


Expressed Expressed ConsentConsent


Implied Implied ConsentConsent


DNRDNR


LIVING WILLLIVING WILL


AbandonmentAbandonment


NegligenceNegligence


RefusalRefusal


Special Special Reporting Reporting SituationsSituations


Crime SceneCrime Scene

DOCUMENTATIONDOCUMENTATION

DocumentationDocumentation

Your written prehospital care report Your written prehospital care report (PCR) is the (PCR) is the only true factual only true factual record of eventsrecord of events..

Your PCR is your sole permanent, Your PCR is your sole permanent, complete written record of events complete written record of events during theduring theambulance call.ambulance call.

Uses for PCR’sUses for PCR’s

Medical Medical AdministrativeAdministrative ResearchResearch LegalLegal

General ConsiderationsGeneral Considerations

Use appropriate medicalUse appropriate medicalterminology.terminology.

Use acceptable and approvedUse acceptable and approvedabbreviations and acronyms.abbreviations and acronyms.

If you do not know how to spell a word, look it up or use another word…

CommunicationsCommunications

The communications with theThe communications with thehospital are another important hospital are another important item to document.item to document.

Document ANY medical advice orDocument ANY medical advice ororders you receive and the results orders you receive and the results of implementing that advice and of implementing that advice and those orders.those orders.

Pertinent NegativesPertinent Negatives

Document all findings of your Document all findings of your assessment, assessment, even those that are normaleven those that are normal..

Remember you are building a case to Remember you are building a case to support your clinical impressionsupport your clinical impression

Oral StatementsOral Statements

Whenever possible, quote the Whenever possible, quote the patient—or other source of patient—or other source of information—directly.information—directly.

Example: Bystanders state the patient was “acting bizarre and threatening to jump in front of the next passing car.”

Elements of Good Elements of Good DocumentationDocumentation

AccuracyAccuracy LegibilityLegibility TimelinessTimeliness Absence of alterationsAbsence of alterations ProfessionalismProfessionalism

ProfessionalismProfessionalism

Never include slang, biasedNever include slang, biasedstatements, or irrelevantstatements, or irrelevantopinions.opinions.

Include only objectiveInclude only objectiveinformation.information.

Always write and speak clearly.Always write and speak clearly.

Narrative WritingNarrative Writing

Subjective part of your narrative comprises Subjective part of your narrative comprises any information that you elicit during your any information that you elicit during your patient’s history.patient’s history.

Objective part of your narrative usually Objective part of your narrative usually includes your general impression and any includes your general impression and any data that youdata that youderive through inspection, palpation, derive through inspection, palpation, auscultation, percussion, and diagnostic auscultation, percussion, and diagnostic testing.testing.

Special ConsiderationsSpecial Considerations

Patient refusalsPatient refusals Services not neededServices not needed Mass casualty incidentsMass casualty incidents

Patient RefusalsPatient Refusals

Patients retain the right to refusePatients retain the right to refusetreatment or transportation treatment or transportation if theyif theyare competent to make that decisionare competent to make that decision..

Two main types of refusals:Two main types of refusals: Person who is not seriouslyPerson who is not seriously

injured and does not want to go to injured and does not want to go to the hospital the hospital

The patient refuses even thoughThe patient refuses even though you feel he needs it. Also known as AMA you feel he needs it. Also known as AMA

A patient’s refusal of care requires careful documentation.

Airway ManagementAirway Management


AnatomyAnatomy


Upper AirwayUpper Airway

Comprised of?Comprised of?



Lower AirwayLower Airway



Opening the Opening the AirwayAirway

- No trauma- No trauma


Opening the Opening the Airway Airway

(Trauma)(Trauma)


BreathingBreathing***Ventilation ***Ventilation

versus versus oxygenationoxygenation


Signs and SymptomsSigns and SymptomsAdequate / Inadequate Adequate / Inadequate

BreathingBreathingCan you list them?Can you list them?


SuctioningSuctioning

How, how long?How, how long?

SuctioningSuctioning

PurposePurpose DevicesDevices MeasurementMeasurement TimeTime ProcedureProcedure

Airway Airway ManagementManagement


Artificial VentilationsArtificial VentilationsAdjuncts-name, Adjuncts-name, measure, insertmeasure, insert

Oxygen devices Oxygen devices

Non-Invasive Non-Invasive Respiratory MonitoringRespiratory Monitoring

Pulse OximeterPulse Oximeter

PATIENT PATIENT ASSESSMENTASSESSMENT

BSIBSI BB BodyBody

SS SubstanceSubstance

II IsolationIsolation

MOI / NOIMOI / NOI MM MechanismMechanism OO ofof II InjuryInjury

NN NatureNature OO ofof II IllnessIllness

SAMPLESAMPLE SS Signs and SymptomsSigns and Symptoms AA AllergiesAllergies MM MedicationsMedications PP Past Medical HistoryPast Medical History LL Last Oral IntakeLast Oral Intake EE Events Leading to the Injury / Events Leading to the Injury /

IllnessIllness

OPQRSTOPQRST OO OnsetOnset PP ProvocationProvocation QQ QualityQuality RR RadiationRadiation SS SeveritySeverity TT TimeTime

DCAP-BTLSDCAP-BTLS

DD DeformityDeformity CC ContusionsContusions AA AbrasionsAbrasions PP Punctures / PenetrationsPunctures / Penetrations

BB BurnsBurns TT TendernessTenderness LL LacerationsLacerations SS SwellingSwelling

Baseline Vital SignsBaseline Vital Signs

RespirationsRespirations

PulsePulse

SkinSkin

PupilsPupils

Blood PressureBlood Pressure

Pulse OxPulse Ox

TemperatureTemperature

Ongoing Ongoing AssessmentAssessment

Repeat Initial AssessmentRepeat Initial Assessment

Reassess Vital SignsReassess Vital Signs

Repeat Focused AssessmentRepeat Focused Assessment

Check InterventionsCheck Interventions


Stable PatientStable PatientHow often?How often?


Unstable PatientUnstable PatientHow often?How often?

Rapid Trauma Rapid Trauma AssessmentAssessment

(Check for DCAP-BTLS)(Check for DCAP-BTLS) HeadHead NeckNeck ChestChest AbdomenAbdomen PelvisPelvis Extremities (PMS)Extremities (PMS) PosteriorPosterior

HeadHeadDCAP-BTLSDCAP-BTLS

EarsEarsDCAP-BTLS + DrainageDCAP-BTLS + Drainage

Neck: DCAP-BTLS + Jugular VeinNeck: DCAP-BTLS + Jugular VeinDistention and CrepitationDistention and Crepitation

Chest: DCAP-BTLS + Crepitation andChest: DCAP-BTLS + Crepitation andBreath Sounds Breath Sounds (Presence and Equality)(Presence and Equality)

Mid-clavicular Mid-clavicular Mid-axillaryMid-axillary

Listen to both sides of the chest. Listen to both sides of the chest. Is air entry present? Absent?Is air entry present? Absent?

Equal on both sides?Equal on both sides?Compare left side to right side.Compare left side to right side.

Abdomen: DCAP-BTLS + Abdomen: DCAP-BTLS + Firmness and DistentionFirmness and Distention

Pelvis: DCAP-BTLS Pelvis: DCAP-BTLS (Compress Gently)(Compress Gently)

Extremities: DCAP-BTLS + DistalExtremities: DCAP-BTLS + DistalPulse, Sensation, Motor FunctionPulse, Sensation, Motor Function

Posterior: DCAP-BTLSPosterior: DCAP-BTLS

TYPES OF TYPES OF PATIENTSPATIENTS

Medical PatientMedical Patient Scene Size UpScene Size Up

SafetySafety

BSIBSI

MOI / NOIMOI / NOI

Patients / ResourcesPatients / Resources

Medical PatientMedical Patient

Responsive Patient Responsive Patient

InitialInitial General ImpressionGeneral Impression

Mental StatusMental Status

ABC’sABC’s

Priority of PatientPriority of Patient

Medical PatientMedical Patient Responsive Patient Responsive Patient

Focused History and Physical ExamFocused History and Physical Exam

Physical ExamPhysical Exam

OPQRSTOPQRST

SAMPLESAMPLE

Medical PatientMedical Patient

Unresponsive Medical Unresponsive Medical PatientPatient InitialInitial

ABC’sABC’s Rule out TraumaRule out Trauma

Focused ExamFocused Exam Rapid AssessmentRapid Assessment

Vitals / SAMPLEVitals / SAMPLE

OngoingOngoing

Patient Assessment Patient Assessment Trauma PatientTrauma Patient

Determine MOIDetermine MOI Significant / Non-SignificantSignificant / Non-Significant

Initial AssessmentInitial Assessment ABC’sABC’s Patient priorityPatient priority Focused History and Physical ExamFocused History and Physical Exam

DCAP- BTLSDCAP- BTLS Rapid trauma assessmentRapid trauma assessment


Rapid Trauma AssessmentRapid Trauma Assessment C-CollarC-Collar Inspect, palpate, auscultateInspect, palpate, auscultate DCAP-BTLSDCAP-BTLS SAMPLESAMPLE Detailed ExamDetailed Exam OngoingOngoing


Rapid Trauma AssessmentRapid Trauma Assessment C-CollarC-Collar Inspect, palpate, auscultateInspect, palpate, auscultate DCAP-BTLSDCAP-BTLS SAMPLESAMPLE Detailed ExamDetailed Exam OngoingOngoing

Trauma PatientTrauma PatientNo Significant MOINo Significant MOI

Initial AssessmentInitial Assessment

Focused History and Physical ExamFocused History and Physical Exam

Ongoing AssessmentOngoing Assessment

PharmacologyPharmacology


Medications on Medications on AmbulanceAmbulance

Oxygen, charcoal oral Oxygen, charcoal oral glucose,glucose,


Prescribed Prescribed MedicationsMedications

Which ones can you Which ones can you assist the patient in assist the patient in taking? After what?taking? After what?


IndicationsIndications


ContraindicatioContraindicationsns


The 4 Rights to The 4 Rights to Med Med

AdministrationAdministration

Medical EmergenciesMedical Emergencies

SeizuresSeizures

SeizuresSeizures

Generalized SeizuresGeneralized Seizures

Tonic-ClonicTonic-Clonic AuraAura

Loss of ConsciousnessLoss of Consciousness

Tonic PhaseTonic Phase

Clonic PhaseClonic Phase

PostseizurePostseizure

PostictalPostictal

SeizuresSeizures

Partial SeizuresPartial Seizures Simple Partial SeizuresSimple Partial Seizures

Involve one body area.Involve one body area. Can progress to generalized seizure.Can progress to generalized seizure. Also known as focal seizuresAlso known as focal seizures

Complex Partial SeizuresComplex Partial Seizures Characterized by auras.Characterized by auras. Typically 1–2 minutes in length.Typically 1–2 minutes in length. Loss of contact with surroundings.Loss of contact with surroundings.

SeizuresSeizures

AssessmentAssessment Differentiating Between Syncope & Differentiating Between Syncope &

SeizureSeizure Bystanders frequently confuse syncope Bystanders frequently confuse syncope

and seizure.and seizure.

SeizuresSeizures ManagementManagement

Scene safety & BSI.Scene safety & BSI. Maintain the Maintain the

airwayairway.. Administer high-Administer high-

flow oxygen.flow oxygen. Treat hypoglycemia Treat hypoglycemia

if present.if present. Do not restrain Do not restrain

the patient.the patient. Protect the Protect the

patient from the patient from the environmentenvironment..

Maintain body Maintain body temperature.temperature.

SeizuresSeizures ManagementManagement

Position the Position the

patient.patient.

Suction if Suction if

required.required.

Provide a quiet Provide a quiet

atmosphere.atmosphere.

Transport.Transport.

SeizuresSeizures

Status EpilepticusStatus Epilepticus Two or More Generalized SeizuresTwo or More Generalized Seizures

Seizures occur without a return of Seizures occur without a return of consciousnessconsciousness..

ManagementManagement Management of airway and breathing is critical.Management of airway and breathing is critical. Monitor the airway closely.Monitor the airway closely.


Stroke (CVA)Stroke (CVA)

Stroke & Intracranial Stroke & Intracranial HemorrhageHemorrhage

Occlusive StrokesOcclusive Strokes Embolic & Thrombotic Embolic & Thrombotic

StrokesStrokes Hemorrhagic StrokesHemorrhagic Strokes

Occlusive StrokesOcclusive Strokes Embolic & Thrombotic Embolic & Thrombotic

StrokesStrokes Hemorrhagic StrokesHemorrhagic Strokes

SignsSigns Facial DroopingFacial Drooping HeadacheHeadache Aphasia/Aphasia/

DysphasiaDysphasia HemiparesisHemiparesis ParesthesiaParesthesia Gait DisturbancesGait Disturbances IncontinenceIncontinence


SymptomsConfusionAgitationDizzinessVision Problems

SymptomsConfusionAgitationDizzinessVision Problems

Transient Ischemic AttacksTransient Ischemic Attacks Indicative of carotid artery disease.Indicative of carotid artery disease. Symptoms of neurological deficit:Symptoms of neurological deficit:

Symptoms resolve in less than 24 Symptoms resolve in less than 24 hourshours..

No long-term effectsNo long-term effects.. Evaluate through history taking:Evaluate through history taking:

History of HTN, prior stroke, or TIA.History of HTN, prior stroke, or TIA. Symptoms and their progression.Symptoms and their progression.


ManagementManagement Scene safety & BSIScene safety & BSI Maintain the airway.Maintain the airway. Support breathing.Support breathing. Obtain a detailed history.Obtain a detailed history. Position the patient.Position the patient. Protect paralyzed extremities.Protect paralyzed extremities.



Allergic Reaction Allergic Reaction (Anaphylaxis)(Anaphylaxis)

Allergies and Allergies and AnaphylaxisAnaphylaxis

Allergic ReactionAllergic Reaction An exaggerated response by the An exaggerated response by the

immune system to a foreign immune system to a foreign substancesubstance

AnaphylaxisAnaphylaxis An unusual or exaggerated allergic An unusual or exaggerated allergic

reactionreaction A life-threatening emergencyA life-threatening emergency The most severe form of allergic The most severe form of allergic

reactionreaction

AnaphylaxisAnaphylaxis CausesCauses

Focused History & Physical ExamFocused History & Physical Exam Focused HistoryFocused History

SAMPLE & OPQRST HistorySAMPLE & OPQRST History Rapid onset, usually 30–60 seconds following Rapid onset, usually 30–60 seconds following

exposure.exposure. Speed of reaction is indicative of severity.Speed of reaction is indicative of severity. Previous allergies and reactions.Previous allergies and reactions.

Physical ExamPhysical Exam Presence of severe respiratory Presence of severe respiratory

difficulty is key to differentiating difficulty is key to differentiating anaphylaxis from allergic reactionanaphylaxis from allergic reaction..

Assessment Findings Assessment Findings in Anaphylaxisin Anaphylaxis

Physical ExamPhysical Exam Facial or laryngeal edemaFacial or laryngeal edema Abnormal breath soundsAbnormal breath sounds Hives and urticariaHives and urticaria Hyperactive bowel soundsHyperactive bowel sounds Vital sign deterioration as Vital sign deterioration as

the reaction progressesthe reaction progresses

Assessment Assessment Findings in Findings in AnaphylaxisAnaphylaxis

Epi-Auto InjectorEpi-Auto Injector

IndicationsIndicationsanaphylaxis anaphylaxis requires??requires??

anaphylaxisanaphylaxis

Difficulty BreathingDifficulty BreathingSystemic Skin reactionsSystemic Skin reactionsHypotensionHypotension


ContraindicatioContraindicationsns


DosageDosage


ActionsActions


Side EffectsSide Effects


AdministrationAdministration

SHOCK is…SHOCK is…INADEQUATEINADEQUATE

TISSUETISSUEPERFUSIONPERFUSION

In a Nutshell…..

OB / GYNOB / GYN

OB / GYNOB / GYN LaborLabor Bloody ShowBloody Show CrowningCrowning Predelivery EmergenciesPredelivery Emergencies

LaborLabor Stage One Stage One

(Dilation)(Dilation) Stage Two Stage Two

(Expulsion)(Expulsion) Stage Three Stage Three

(Placental (Placental Stage)Stage)

Management of a Patient Management of a Patient in Laborin Labor

Transport the patient in labor unless Transport the patient in labor unless delivery is imminent.delivery is imminent.

Maternal urge to push or the Maternal urge to push or the presence of crowning indicates presence of crowning indicates imminent delivery.imminent delivery.

Delivery at the scene or in the Delivery at the scene or in the ambulance will be necessary.ambulance will be necessary.

Transport the patient in labor unless Transport the patient in labor unless delivery is imminent.delivery is imminent.

Maternal urge to push or the Maternal urge to push or the presence of crowning indicates presence of crowning indicates imminent delivery.imminent delivery.

Delivery at the scene or in the Delivery at the scene or in the ambulance will be necessary.ambulance will be necessary.

Field DeliveryField Delivery

Set up delivery area.Set up delivery area. Give oxygen to mother Give oxygen to mother

and start and start Drape mother with Drape mother with

toweling from OB kit.toweling from OB kit. Monitor fetal heart Monitor fetal heart

rate.rate. As head crowns, apply As head crowns, apply

gentle pressure.gentle pressure.

Suction the mouth and then the nose.Clamp and cut the cord.Dry the infant and keep it warm.Deliver the placenta and save for transport with the mother.

Suction the mouth and then the nose.Clamp and cut the cord.Dry the infant and keep it warm.Deliver the placenta and save for transport with the mother.

OB / GYN ( Normal OB / GYN ( Normal Delivery)Delivery)

Head Delivers


Suction mouth, nose.


Delivery of Shoulders

Chest Delivers


Legs and Feet Deliver


Cutting the Cord


Cutting Umbilical Cord

Apgar ScoringApgar Scoring


Care of Care of NewbornNewborn

OB / GYN OB / GYN (Resuscitation)(Resuscitation)

HR Less than HR Less than 100100


HR less than HR less than 8080


HR less than HR less than 6060

Neonatal ResuscitationNeonatal Resuscitation

If the infant’s respirations are below 30 If the infant’s respirations are below 30 per minute and tactile stimulation does per minute and tactile stimulation does not increase rate to normal range, not increase rate to normal range, assist ventilations using bag valve mask assist ventilations using bag valve mask with high-flow oxygen.with high-flow oxygen.

If the heart rate is below 80 and does If the heart rate is below 80 and does not respond to ventilations, initiate not respond to ventilations, initiate chest compressions.chest compressions.

Transport to a facility with neonatal Transport to a facility with neonatal intensive care capabilities.intensive care capabilities.

Causes of Bleeding Causes of Bleeding During PregnancyDuring Pregnancy

AbortionAbortion Ectopic pregnancyEctopic pregnancy Placenta previaPlacenta previa Abruptio placentaeAbruptio placentae

AbortionAbortion Ectopic pregnancyEctopic pregnancy Placenta previaPlacenta previa Abruptio placentaeAbruptio placentae

Ectopic PregnancyEctopic Pregnancy

Assume that any female of Assume that any female of childbearing age with lower childbearing age with lower abdominal pain is experiencing an abdominal pain is experiencing an ectopic pregnancy.ectopic pregnancy.

Ectopic pregnancy is life-Ectopic pregnancy is life-threatening. Transport the patient threatening. Transport the patient immediately.immediately.

Placenta PreviaPlacenta Previa Usually presents Usually presents

with painless with painless bleeding.bleeding.

Never attempt Never attempt vaginal exam.vaginal exam.

Treat for shock.Treat for shock. Transport Transport

immediately—immediately—treatment is treatment is delivery by delivery by c-section.c-section.

Abruptio PlacentaeAbruptio Placentae Signs and Signs and

symptoms vary.symptoms vary. Classified as Classified as

partial, severe, or partial, severe, or complete.complete.

Life-threatening.Life-threatening. Treat for shock, Treat for shock,

fluid resuscitation.fluid resuscitation. Transport left Transport left

lateral recumbent lateral recumbent position.position.

Abnormal Delivery Abnormal Delivery SituationsSituations

OB / GYN (Abnormal OB / GYN (Abnormal Deliveries) Deliveries)

BreechBreech

Breech PresentationBreech Presentation

The buttocks or both feet present The buttocks or both feet present first.first.

If the infant starts to breath with If the infant starts to breath with its face pressed against the its face pressed against the vaginal wall, form a “V” and push vaginal wall, form a “V” and push the vaginal wall away from the vaginal wall away from infant’s face. Continue during infant’s face. Continue during transport.transport.

OB / GYN (Abnormal OB / GYN (Abnormal Deliveries) Deliveries)

Prolapsed Prolapsed CordCord

Prolapsed CordProlapsed Cord The umbilical cord precedes the fetal The umbilical cord precedes the fetal

presenting part.presenting part. Elevate the hips, administer oxygen, and Elevate the hips, administer oxygen, and

keep warm.keep warm. If the umbilical cord is seen in the vagina, If the umbilical cord is seen in the vagina,

insert two gloved fingers to raise the fetus insert two gloved fingers to raise the fetus off the cord. Do not push cord back.off the cord. Do not push cord back.

Wrap cord in sterile moist towel.Wrap cord in sterile moist towel. Transport immediately; do not attempt Transport immediately; do not attempt

delivery.delivery.

OB / GYN (Abnormal OB / GYN (Abnormal Deliveries)Deliveries)

Limb Limb PresentationPresentation

Limb Presentation Limb Presentation With limb presentation, With limb presentation,

place the mother in knee–place the mother in knee–chest position, administer chest position, administer

oxygen, and transport oxygen, and transport immediately. Do not attempt immediately. Do not attempt

delivery.delivery.

Other Abnormal Other Abnormal PresentationsPresentations

Whenever an abnormal presentation or Whenever an abnormal presentation or position of the fetus makes normal position of the fetus makes normal delivery impossible, reassure the delivery impossible, reassure the mother.mother.

Administer oxygen.Administer oxygen. Transport immediately.Transport immediately. Do not attempt field delivery in these Do not attempt field delivery in these

circumstances.circumstances.

Whenever an abnormal presentation or Whenever an abnormal presentation or position of the fetus makes normal position of the fetus makes normal delivery impossible, reassure the delivery impossible, reassure the mother.mother.

Administer oxygen.Administer oxygen. Transport immediately.Transport immediately. Do not attempt field delivery in these Do not attempt field delivery in these

circumstances.circumstances.

Other Delivery Other Delivery ComplicationsComplications


Multiple Multiple BirthsBirths

Multiple BirthsMultiple Births

Follow normal guidelines, but Follow normal guidelines, but have additional personnel and have additional personnel and equipment.equipment.

In twin births, labor starts earlier In twin births, labor starts earlier and babies are smaller.and babies are smaller.

Prevent hypothermia.Prevent hypothermia.


MeconiumMeconium

Meconium StainingMeconium Staining

Fetus passes feces into the Fetus passes feces into the amniotic fluid.amniotic fluid.

If meconium is thick, suction the If meconium is thick, suction the hypopharynx and trachea using an hypopharynx and trachea using an endotracheal tube until all endotracheal tube until all meconium has been cleared from meconium has been cleared from the airway.the airway.

Documents

EMERGENCY MEDICAL TECHNICIAN Review – 1 st half Compiled by Barry Barkinsky EMS-I