Trauma in preg

  1. why does major trauma in preg require special consideration?
    • particularly during 3rd trimester- foetus >22 weeks is considered viable if delivered 
    • may cause placental abruption
    • mother has enlarged internal organs and structures- pushing the diaphragm up and enlarging the abdominal cavity
  2. what are the physiological differences with a preg women to non preg?
    • increased cardiac output by 20-30% in the first 10 weeks of preg 
    • increased RR and effort as foetus enlarges 
    • increased maternal HR by 10-15 bpm 
    • decrease in bp by 10-15 mmHg
    • increased blood volume by up to 45%
  3. what can a preg women tolerate more?
    higher blood volume loss before showing signs of shock
  4. what does the uterus act as?
    • reservoir for blood 
    • think- what is revealed? what is concealed?
  5. when does tachycardia set in in preg people?
    • at 30% blood loss 
    • compared to 15% in non preg
  6. what is the compensation for blood loss at the expense of?
    • compensation of blood loss occurs at the expense of the foetus 
    • blood is shunted away from the foetus and towards the mothers vital organs
  7. what are the signs and symptoms?
    • primary survey problems
    • Increased RR (first vital sign change to occur)
    • Increased HR >100
    • Abdominal pain 
    • vaginal blood loss
    • reduced fetal movements  
    • hypotension (last vital sign change to occur)
  8. what should be noted in the assessment?
    any shoulder tip pain
  9. in a pregnancy >20 weeks gestation, what is there a risk of?
    • compressing the vena cava and aorta
    • reducing the blood supply to the foetus
  10. how should a pt >20 weeks preg be placed?
    • left lateral tilt position to be transported
    • placing a support behind her buttocks
  11. what happens if the pt is fully immobilised?
    pt should be tilted at 15-30 degrees on the long board
  12. when should manual uterine displacement be used?
    when the pregnancy is >20 weeks gestation
  13. what are some of the complications of trauma in pregnancy?
    • placenta abruption 
    • bleeding 
    • signs of shock 
    • compression of inferior vena cava 
    • 2 patients to consider and treat
  14. when may placenta abruption occur after trauma?
    • immediately 
    • take 3-4 days to occur 
    • any abdominal trauma in pregnancy must be conveyed
  15. how would you recognise the deteriorating patient?
    • look for signs of shock 
    • look for compensatory systems 
    • reassess pt regularly- note and act on any changes to vital signs
Card Set
Trauma in preg
Trauma in preg