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2012 TN EMT-IV, Brady 9th ed.

FULL TERM

38 to 40 weeks

UTERUS

Organ expands for baby to grow

PLACENTA

Organ of pregnancy; link between uterus and fetus

AMNIOTIC SAC

500-mL shock absorber

IMBILIBAL CORD

Fetus lifeline

MUCOUS PLUG

Cervix sealed to stop infection

MATERNAL BLOOD VOLUME

Increases by 45%

MATERNAL RESPIRATORY TIDAL VOLUME

Increases by 40%

MATERNAL HEART RATE

Increases by 10-15 bpm

HYPOVOLEMIA

Leading cause of death in pregnant women

SPONTANEOUS ABORTION

Termination under 20 weeks

PLACENTA PREVIA

Placenta implantation over cervix, painless bleeding

ABRUPTIO PLACENTA

Placenta rips from uterus; constant painful bleeding

RUPTURED UTERUS

'Tearing' sensation without fetal movement

ECTOPIC PREGNANCY

Fetus development not in uterus (F. Tubes)

PREECLAMPSIA

Gestational HTN with possibility of seizures

ECLAMPSIA

Gestational HTN and seizure disorder

SUPINE HYPOTENSIVE SYNDROME

Fetus occluding Vena Cava

GRAVIDA

How many pregnancies?

PARA

How many births?

3 STAGES OF LABOR

Dilation, Expulsion, Placenta

BRAXTON-HICKS CONTRACTIONS

False Labor

CONTRACTIONS AT BIRTH

Every 2 to 3 minute, lasting approx. 1 minute long

DELIVERY STEPS FOR BABY

Head, neck, suction, shoulders

STEPS FOR NEONATE

Stimulate/Dry, Clampx2, Cut cord

POST DELIVERY CARE

Loose dressing, Fundal massage, Breast Feed

PROLAPSE CORD

Insert hand to relieve head from compressing cord, wrap in moist dressing

BREECH BIRTH

Insert hand to establish airway for baby

LIMB PRESENTATION

Do not touch! May stimulate baby to breath

MECONIUM

Suction airway

PREMATURE

Under 38 weeks or 5 pounds

POST-TERM

Over 42 weeks

PRECIPITOUS DELIVERY

Fast with tearing

SHOULDER DYSTOCIA

'Turtle Sign'; McRobert's position of supine with knees to chest

PRETERM LABOR

Onset of labor prior to term; treat mom for shock and baby may stay

MULTIPLE BIRTHS

Call for more help. Second may be breech (33%)

PREMATURE RUPTURE OF MEMBRANES

'Water broke'= mucus plug ruptures; not labor

APGAR

Appearance, Pulse, Grimace, Activity, Respirations

INVERTED NEONATAL PYRAMID

Stimulate, O2 blowby, BVM @ HR 100 HR, CPR @ 60 HR; reevaluate every 30 seconds

NEONATE

Newborn to 1 month

INFANT

1 month to 1 year; roll over4/ sit up 6/ crawl9

TODDLERS

1-3 years; walking/ talking

PRESCHOOL

3-6 years; dressing4/ tying shoes6

SCHOOL-AGE

6-12 years

ADOLESCENT

12-18 year; teenagers

PEDIATRIC ASSESSMENT TRIANGLE

Appearance, work of Breathing, Circulation; 1st impression of Sick or Not Sick

TICLS

Tone, Interactiveness, Consolability, Look/gaze, Speech/cry

PEDIATRIC SHOCK

Not hypotensive until 30% volume lost; compensate well then suddenly crash!

NORMAL B/P RULE FOR PEDIATRICS

Age x 2 + 80

FONTANELLE

Assess for hydration status in neonate/infant

RR UNDER 5 Y/O

2-3 x faster than adult

CAUSE OF CARDIAC ARREST

Respiratory compromise

AIRWAY POSITIONING

Modified jaw thrust; no head-tilt - big head! Pad shoulders to maintain neutral alignment

TIDAL VOLUME

6-8 mL/kg

PEDIATRIC FLUID BOLUS

Personally, I would start at 10 mL/kg

CROUP

'Seal-bark' cough; do NOT agitate, humidify O2

EPIGLOTTITIS

Drooling; 50% mortality rate; do NOT agitate, humidify O2

ASTHMA

Bronchoconstriction with + mucous production, wheezing; albuterol

CONGENITAL HEART DISEASE (CHD)

Family states significant history; support ABCs

FEBRILE SEIZURES

Sudden spike in temperature; treat for seizure, passive cooling, BGL

MENINGITIS

Lethargic, hot to touch; painful movement (of head), possible rash; PPE!

SIDS/SUDDEN INFANT DEATH SYNDROME

'Crib Death' to age 1; CPR unless rigor or lividity

DUCTUS ARTERIOSIS

Heart bypass of fetus

DUCTUS VENOSUS

Imbilical bypass of fetus

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