孕妇创伤急救.ppt

Discussion * Trauma in Pregnancy - Key Lecture Points Cover the general information included in the lecture slides, including the information associated with the various trimesters. Note should be made that the status of the fetus generally depends on the well-being of the mother. Therefore, if the mother has adequate blood volume, blood pressure, and circulation, then the fetus will do well. Use the quote: “Death of the fetus in the trauma situation is most often associated with the death of the mother.” Mention that the treatment of shock is the same for pregnant patients as for other patients. Emphasize that the physiologic changes of pregnancy may cause delay in the diagnosis of the shock state in the mother. Stress that uterine obstruction of venous blood flow may cause hypotension in the supine patient (“supine hypotension syndrome”), and thus must be prevented by rolling the patient or backboard to the left. Note that there is an increased rate of fetal demise 2 or 3 days following major trauma to the mother. Mention that short backboard-type device may be ineffective as an SMR device in the pregnant patient because of the difficulty with adequately securing the straps. This concern also applies to the very obese patient. International Trauma Life Support, 6e * * International Trauma Life Support, 6e * Major goals in caring for pregnant trauma are evaluation and stabilization. All prehospital interventions directed toward optimizing both fetal and maternal outcome. Optimal care for fetus is appropriate treatment of mother. * Because minor injuries rarely present problems for EMS providers, ITLS focuses on more severe traumatic injuries to pregnant patient. Leading cause of morbidity and mortality: 6–7% of pregnancies are complicated by accidental trauma. Approximately 8% (1 in 12) of those are significant. MVCs are most common cause (65–70%). * The pregnant patient is often at risk for a higher incidence of accidental trauma. Increase in fainting spe