EMS World

OCT 2018

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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Page 31 of 87

EMSWORLD.com | OCTOBER 2018 31 out pregnancy, undiagnosed eclampsia can occur in any birth set- ting and during pregnancy, birth, or postpartum. In this case EMS would be needed immediately. Magnesium sulfate is typically the first-line agent for acute treatment and prophylaxis of seizures in eclampsia and pre-eclampsia. Prolapsed cords are rare but can happen in any birth environ- ment. Midwives should also possess the skills to deal with these. EMS assistance may be needed in moving and positioning the patient or possibly starting an IV. Based on state laws, some mid- wives carr y terbutaline to slow labor. Hemorrhaging after deliver y is not an uncommon hazard. Mid- wives are ver y good at managing the risk factors and bleeds should one arise. If the midwife has maxed out the protocol for Pitocin, Methergine, Cy totec, and fluid resuscitation, a call for help would be in order. If you have Pitocin in your med box, use it. Newborn respirator y distress is another complication. Most babies in this categor y just need a few puffs of air to be good to go. However, when the baby is not responding, help will be needed. Skills like umbilical cord cauterization and initiating IOs for certain meds will not be a part of midwives' protocols. Control the Chaos Having worked both sides of a critical care mother/baby transfer, one thing seems constant in such situations: chaos. EMS can help avoid confusion on scene by following these steps. Step 1—Identify yourself, the lead midwife, and the patient(s). A great way to star t would be, "Hello, my name is Jessica. I'm a paramedic with XYZ Ambulance Company. Who is the lead midwife, and who is the patient?" This eliminates any confusion right off the bat and sets the stage for professionalism and rap- port—crucial when time is of the essence. By introducing yourself, you have eliminated any question about scope of practice in the midwife's mind. Out-of-hospital midwives often work in a team environment, so identif ying the lead midwife is important, as they will provide information about the patient and why EMS was called. Identif ying the patient is also important, as it may not always be necessar y to transpor t both mother and baby. Several years ago I attended a birth that went well, but as I tried to deliver the placenta, it would not come out. I attempted assisted deliver y and administered Pitocin with the IV fluid, but mom continued to bleed. Other midwife staff called 9-1-1. A paramedic unit and the fire depar tment arrived. Upon arrival the entire group looked at me with a "what do we do?" look. I identified myself and the rest of the team and proceeded to give the report: whom the patient was, what we needed, and where we would be going. The mother was the patient, not the baby. The baby stayed with the father and the rest of the midwife team for transitioning and stabilization, while I accompanied the mom and paramedic to the hospital. Once I established the lead and assigned roles, comanaging the patient was seamless. Step 2—Ask how you can help and assign roles. Picture this: A resuscitation of a newborn is in full swing. Ask if the midwife needs to switch out and where they are in the inverted EMERGENCY MEDICAL SCIENCE www.lenoircc.edu/publicsafety PARAMEDIC CERTIFICATION (HYBRID PROGRAM) ■ Fully CAAHEP Accredited ■ Hybrid Paramedic program offered through LCC Continuing Education Department. Various formats available with weekday or weekend onsite options and evaluations. All coursework is done online. Tuition, Books, and Fees estimated at $1,700.00. ■ Available to students from NC, VA, SC, GA, WV, KY, VT, PA, and CA. ■ Different course options that allow currently credentialed EMTs and AEMTs, WRWUDLQIRUWKHLU3DUDPHGLFFHUWL¿FDWLRQ ■ Graduates are eligible for the NCOEMS Paramedic exam and the National Registry Paramedic exam. BRIDGE TO AN ASSOCIATE DEGREE IN EMERGENCY MEDICAL SCIENCE ■ All degree classes offered 100% online. ■ Articulation Agreement with 4-Year Universities. ■ Currently credentialed state and national Paramedics earn up to 45 credits toward WKHLUGHJUHHMXVWIRUEHLQJFHUWL¿HG ■ Available to residents in all states except FL and MA. ■ Designed for demanding EMS work schedules. Complete the degree DW\RXURZQSDFH EARN YOUR DEGREE ONLINE! 231 Hwy. 58 South, Kinston, NC (252) 527-6223, ext. 115 jgtilghman38@lenoircc.edu Ranked Fourth in the Nation by bestcolleges.com! For More Information Circle 26 on Reader Service Card

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