Case Study Chapter 25 Gynecologic Emergencies Your ambulance is dispatched to a local residence for a 20-year-old female with vaginal bleeding. When you inform dispatch that you are responding, you are advised that the caller states she is
"Case Study Chapter 25 Gynecologic Emergencies Your" is the property of its rightful owner. Permission is granted to
download and print the materials on this website for personal, non-commercial use only, and to display it
on your personal computer provided you do not modify the materials and that you retain all copyright
notices contained in the materials. By downloading content from our website, you accept the terms of this
agreement.
Presentation Transcript
01
Case Study Chapter 25
Gynecologic Emergencies<br>
02
Your ambulance is dispatched to a local residence for a 20-year-old female with vaginal bleeding.
When you inform dispatch that you are responding, you are advised that the caller states she is 8½ months pregnant with her first child and has bright red vaginal bleeding. Part 1<br>
03
Part 1 1. What are some causes of vaginal bleeding during pregnancy?
2. What is a very serious cause of bright red, third-trimester bleeding?<br>
04
As you arrive on scene, a frantic husband directs you to his wife, who is in the back bedroom on the bed.
The patient tells you that she is 8½ months pregnant and has had no complications with this pregnancy. She states that the bleeding began 30 minutes ago and is accompanied with moderate, constant abdominal pain. You note a large quantity of bright red blood. Part 2<br>
05
3. Is this a life-threatening emergency?
4. In regard to this pregnancy, what are some questions that you should ask the patient related to the problem she is experiencing? Part 2<br>
06
Part 3 You direct your partner to place the patient on a nonrebreathing mask while you obtain a set of vital signs. You get a pulse rate of 135, blood pressure of 72/P, and respirations of 26. You are unable to obtain a pulse oximetry reading.
Recognizing the seriousness of the situation, you quickly prepare the patient for transport by placing her on the stretcher, loading her into the back of the ambulance, and initiating emergent transport.<br>
07
Part 3 5. With continued vaginal bleeding, should the AEMT place an absorbent pad into the vagina to stop bleeding?
6. How should the abdomen be examined?<br>
08
Part 4 You quickly establish bilateral IVs and infuse a 250-mL bolus of normal saline. In an attempt to stem the flow of blood, you place absorbent dressings against the vagina, making sure not to place them inside. You also place the patient in the shock position based upon her vital signs, tilting her toward the left side to decrease fetal compression of her vena cava.
Upon your arrival at the ED, you are directed to the labor and delivery unit and turn over care to the awaiting OB physician.<br>
09
Part 4 7. What is an appropriate facility for this patient?
8. Is there any risk to the fetus in this case?<br>
10
Summary Gynecologic emergencies present a frightening experience both for the patient and for many prehospital providers. The AEMT must ensure compassion and professionalism when dealing with gynecologic emergencies. When at all possible, the AEMT assessing a gynecologic complaint should be a female, in an attempt to foster a trusting relationship with the patient.<br>
