Trauma In Pregnancy–Nursing Notes

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Trauma

– Leading cause of death during pregnancy
– MVA’s cause 50% of prenatal mortality
– Consider possible pregnancy in any female trauma patient of childbearing age

Trauma In Pregnancy

– Priorities same as in non-pregnant patient
– ABC’s

Alterations In Pregnancy

  • As pregnancy progresses:
    – Heart rate increases
    – Blood pressure decreases
  • Normal pregnant vital signs mimic hypoperfusion
  • Assessment more difficult

Alterations In Pregnancy

  • Blood volume increases by 40-50%
    – 30% blood loss may occur before shock signs and symptoms develop
    – Reversal of hypoperfusion more difficult
  • Blood flow to uterus, placenta can be selectively reduced
    – Fetus can be in distress while mother appears stable
    – Adequate resuscitation of mom does NOT ensure adequate resuscitation of baby
  • Uterus can compress inferior vena cava when patient is supine
    – Decreases cardiac output 30 – 40%
    – Do NOT put pregnant patients in supine position!

Management

  • Airway
  • C-spine control
  • High flow O2
  • – 3rd trimester O2 demand increases 10-20%
  • Assist ventilation
  • If MAST used, inflate legs only
  • Transport patient:
    – on left side, or
    – elevate right side of spine board

Data from: from Temple College

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Posted in Maternity, Nursing Care Plans, Nursing Intervention

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