PCP Case Study Pregnancy Standard 3 PDF

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Paramedic Program

Self-

Directed Case Study – PCP

Case #3 Pregnancy Standard Incident History You are dispatched to a residence for a female patient with a severe abdominal pain and 38 weeks gestation. She tells the dispatcher she is sitting in her car because she was going to try and drive herself to the hospital but the pain is too severe. Physical Assessment Upon your arrival you note a female sitting in a car, in severe pain. She tells you the pain comes and goes on a regular basis and she’s afraid the baby is coming. You confirm she is having contractions, lasting approx. 1 minute and are reoccurring about every 2 minutes. She tells you she feels like she needs to have a bowel movement, and it really hurts in her lower back when the contractions occur. She was trying to get to the hospital; her husband is meeting her there. She is not sure if this is real or false labor. Past Medical History /Medications / Allergies Allergies: Medications: PMHx:

none prenatal vitamins this is her first baby, first pregnancy. She is due in 2 weeks.

Vital Signs HR: radial pulse is approximately 110bpm RR: respirations are shallow, and irregular BP: automatic states 130/70 SpO2: 98% on room air PUPILS: 3 and reactive

Group Worksheet # 3 Case Study 1. Name your differential diagnosis you need to work through when you first see the patient? a. ___________________ b. ___________________ 2. What is her Gravida & Para status? a.

______________________________

3. What is one question you need answered surrounding the onset of her labor earlier today? a.

__________________________________

4. What is your working diagnosis? How long will you stay on scene if delivery does not progress? a. b.

_____________________________________ _____________________________________

5. Which standards within the BLS & or ALS manual does the Paramedic need to consider: name at least 5 – try to pick the most relevant: a. __________________________________ b. __________________________________ c. __________________________________ d. __________________________________ e. __________________________________ f. __________________________________ 6. While you are questioning the pt. and physically assessing the pt what equipment are you ensuring is applied to the pt & other procedures? (Include anatomical locations) a. ______________________________________ b. ______________________________________ c. ______________________________________ d. ______________________________________ e. ______________________________________ f. ______________________________________ g. ______________________________________

Paramedic Program

7. What is your extrication plan to get pt. to stretcher is extrication necessary? Plus what position on stretcher or in car (how would you obtain this position)? a. ______________________________________________ b. ______________________________________________ c. ______________________________________________ d. ______________________________________________ 8. Name 4 signs/symptoms that would make you decide delivery is imminent? a. _____________________________________ b. _____________________________________ c. _____________________________________ d. _____________________________________ Pathophysiology Questions: 9. What are the 3 stages of Labor? a. __________________________________ b. __________________________________ c. __________________________________ 10. Why is it best to have the pt bring her knees up & abduct them? What is the name for this procedure? a. ___________________________________ b. ___________________________________ 11.

What are the indications of Braxton & Hicks contractions? a. _______________________________ b. _______________________________ c. _______________________________

12.

What is crowning and what does this mean to the Paramedic? a. _______________________________ b. _______________________________

Last Question to think about “what would you say?” MC: The patient is crying and saying she did not plan on having a baby in a car, alone without her husband. Your best response would be: 1. It’s OK, people have babies all the time in cars. It will be fun. 2. I see you’re upset, but that is not doing you or your unborn baby any good. So lets just focus on having a baby. 3. I can see how upset you are, and that’s ok. But right now I cannot be distracted by you’re crying as I need to focus on delivering this baby. Lots of people have babies at home, so don’t worry about it, just focus on your breathing.

4. I can see you are getting upset, and that’s only normal to worry about having your baby in a car and without your husband. You have us here with you, and together we are all going to work on delivering this baby....