You are working as part of a double Emergency Care Assistant (ECA) crew on a short 9-5 shift. You’ve just booked on the Ambulance and a Cat 1 call is sent to your MDT screen. Control contact you to advise that you are being to a maternal cardiac arrest. The patient is 33/40 weeks pregnant. You have Paramedic back up which will be 10 minutes behind you.
You arrive on scene and walk into the property to find the patients’ partner conducting CPR. He explains his wife choked on some food, went blue, and then collapsed. He gave back slaps and managed to remove the obstruction, but they are now in cardiac arrest.
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You quickly assess the airway which looks clear, and check for a pulse and breathing. You confirm cardiac arrest to your colleague, and they start to get the defibrillator ready. You take over chest compressions from the husband. You find they are difficult to maintain in the typical central sternum location due to the height of the fundus. What can you do to assist this?
You move your hand position higher on the sternum and find this easier to complete compressions. While conducting chest compressions on this patient, what must you also implement?
The husband is eager to assist and helps maintain uterine displacement while you conduct chest compressions. Your colleague has placed the AED pads and it comes back with ‘no shock advised’. You continue to manage chest compressions as your colleague passes you a BVM and basic airway management kit. You start to ventilate the patient but note some resistance to your efforts. With a pregnant patient, what higher risk is present with regards to airway management?
Where the skill set allows, early consideration should be given to which airway adjunct when dealing with a pregnant patient?
You confirm the airway is still clear and place an SGA which significantly improves your ventilation of the patient. You continue conducting BLS until the next AED rhythm check. I comes back as ‘no shock advised’. You look to your colleague as you are aware that time is starting to pass. Ideally, what is the maximum amount of time you should spend on scene conducting resuscitation before extricating to hospital?
5 minutes has already passed of BLS resuscitation with no change to the patients’ status. Given this scenario, should you look to start extricating the patient even though Paramedic support hasn’t arrived yet?
You discuss that by the time the patient is on the Ambulance, Paramedic back up will be on scene, and you will be ready to transport. Your colleague takes over solo CPR while you get the stretcher. You remember that a left tilt alongside the left manual uterine displacement can help. At what angle is this aimed to be?
You place some padding on the stretcher to help with the left tilt and extricate the patient to the Ambulance. The husband continues to maintain manual uterine displacement. How long does this have to be conducted throughout the resuscitation?
The patient is on the Ambulance and you can see the Paramedic support pulling up. The cause of this arrest is hypoxia, which you have managed through airway and breathing support. What other reversible cause is common within pregnant patients?
The Paramedic steps onto the Ambulance, what correct information do you handover?
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