OB October

Assessing the OB PatientTreating Fevers in the Infant and Child Patient TVEMS Staff Training Objectives : Objectives for this training: Discuss all the medical reasons for prehospital providers to be involved with the OB patient Discuss treatments of prehospital emergencies to include fevers in infants and children Discuss protocols and review definitions in OB terminology Review the training outline for the rest of October! Assessing the OB PatientTreating Fevers in the Infant and Child Patient TVEMS Staff Training Objectives

Assessing the OB Patient : Assessing the OB Patient What are the FIRST questions you want to ask your pregnant patient? What is the difference between the first pregnancy and the 5th? What are YOUR immediate concerns?

Assessing the OB Patient : Assessing the OB Patient Is birth imminent? If so what do you need? List reasons why a pregnant person would call 911 What are the most common? Assessment tools Blood Pressure Pulse Breathing Skin Parameters Blood sugar Abd pain vs. contractions

Assessing the OB Patient : Assessing the OB Patient Assessment Tools: Trauma Medical Prenatal care High risk pregnancy Multiples Drugs and or alcohol Assessment tools: How far apart are the contractions? When did they start? Mid wife present? Natural in the home birth? Bath tub, religious beliefs On the way to the Hospital birth? Do we have time to move the patient? Extra people needed?

Assessment of the OB Patient : Assessment of the OB Patient What are some common cause of premature labor? What is a common cause of fainting in the third trimester? How should we transport our pregnant patients? TVEMS Protocols Dealing with OB patients: Abdominal Pain B-1 Any History of pregnancy Syncope B-21 Ectopic pregnancy rupture? Hypovolemic Shock E-3 Ruptured Ectopic Vaginal bleeding Ativan F-9.1 Under precautions to administer

Assessment of the OB Patient : Assessment of the OB Patient TVEMS protocols dealing with the OB patient : Valium F-13 Under precautions for administration Etomidate F-18 Under precautions for administration TVEMS protocols dealing with the OB patient: Magnesium Sulfate F-24 >20 weeks with signs and symptoms of preeclampsia/eclampsia Administration is 2-4 grams in 100ml NS over 10-15 min Administration is 2-4 grams in 10-15 min for clinically significant pre/elcampsia

Assessment of the OB Patient : Assessment of the OB Patient TVEMS protocols dealing with the OB patient: Succinylcholine F-35 Under precautions for administration Cooling Therapy G-3.1 Contraindications for therapy is obvious pregnancy Child Birth H-2 The whole protocol  TVEMS protocols dealing with the OB patient: Vaginal hemorrhage H-6 Under Information needed Trauma or any other complications of the pregnancy Treatment Refusals J-5 Must contact a Dr and do AMA for trauma related calls

Treating the Infant and Child with a Fever : 15 questions to help treat the fever in infants and children: 1) 2 months or younger with a fever of 100.4 or higher? Yes---Maybe a serious infection needs to be seen ASAP 2) Older than 2 months with a fever of 102 or higher that is unresponsive to fever reducing treatments? Yes---Rule out pneumonia with cough, chills and chest pain 3) Does the child have a low grade fever of 101 or less with a runny nose, tired and cranky? Yes--- cold or flu Treating the Infant and Child with a Fever

Treating the Infant or Child with a fever : 15 questions to help treat the fever in infants and children: 4) Low grade fever of 101 or under and a harsh barky cough? Yes---Croup 5) Low grade fever of 101 or lower with nausea and vomiting? Yes---ear infection or teething are most common 6) Low grade fever with watery diarrhea? Yes---Simple GI bug watch for dehydration Treating the Infant or Child with a fever

Treating the Infant or Child with a Fever : 15 questions to help treat a fever in infants or children: 7) Low grade fever with pulling at one ear or both, irritable, drooling and clear runny nose? Yes---Ear infection and or teething, common to see them together 8) A fever with a rash, cut or wound that is red, swollen or tender? Yes---May be an infection in the cut or wound or cellulitis Treating the Infant or Child with a Fever

Treating the Infant or Child with a Fever : 15 Question to help treat a fever in infants and children: 9) Low grade fever with a very sore throat? Yes---Most likely strep throat 10) Fever with shortness of breath, wheezes, drooling, and bluish lips? Yes---Epiglottis needs to be seen ASAP 11) Low grade fever with rapid breathing, slight wheezes, and raspy sounds? Yes---Bronchitis type issues Treating the Infant or Child with a Fever

Treating the infant and Child with a Fever : 15 questions to help treat a fever in infants and children: 12) Fever with larger blisters scattered over the face, stomach and back areas? Yes---Most likely Chickenpox! 13) Did they have a fever followed 4 or 5 days later with small red bumpy rash? Yes---most likely the Measles Treating the infant and Child with a Fever

Treating an Infant or Child with a Fever : 15 questions to help treat a fever in infants and children: 14) Fever with swelling under the jaws either on one or both sides? Yes---Most likely Mumps 15) Any High grade fever with runny nose, diarrhea, vomiting and sleepy? Yes---Viral infection that needs to be seen Treating an Infant or Child with a Fever

Treating an Infant or Child with a Fever : Treating an Infant or Child with a Fever Treat the life threats first Immediate airway issues Low oxygen concentrations Treat the fever Fever reducing agents Anacetomeniphon Children's/infants Motrin Treat any other symptoms as appropriate Nebulizers Fluids

Seizures in Infants and Children : Seizures in Infants and Children What is the most common cause of the seizure in a child? Why would an infant have a seizure? At what age does Epilepsy usually start? Can an infant have a hypoxic seizure?

Seizures in Infants and Children : Seizures in Infants and Children Treatments: O2, high flow Suctioning may be needed IV access, if first time seizure unassociated with a fever Is the Seizure still active? Pharmacological interventions Versed Ativan