Fundamentals of Midwifery: A Textbook for Students (154 page)

Support for women, their families and midwives is essential following an emergency.

Regular updates and skills drills will support midwives in managing emergency situations.

This chapter has introduced the topic of emergencies in midwifery. The early detection of com-

plications and deviations from the normal in pregnancy and childbirth are a vital part of mid- wifery care. Midwives can provide interventions in emergency situations that can enhance the outcomes for the mother and baby and work with the interprofessional team to provide obstet- ric and medical management. Whilst the assessment, detection and first-line treatment of emer- gencies is absolutely vital so is the psychological support midwives can provide for the woman and her family. Communication is central to this support; it is essential that midwives have the knowledge and skill to offer information and explanations as emergencies are anxiety provok- ing and frightening situations. Record keeping in relation to the interventions given and the timing of these is also key to ensuring that safe, effective care is provided throughout.

1

2 3

4

5

6

7

8 9

369

10

11

Low molecular weight drug used in the treatment of thromboembolism.

Placental separation in the antenatal period.

Tissue damage cause of PPH.

One of the major symptoms of pre- eclampsia.

The blood pressure reading that is below 90 mmHg in shock.

Type of shock associated with pulmonary embolism.

Eclampsia is characterised by this.
Down

The‘B’in ABC assessment in basic life support stands for this.

Essential element of MDT working.
5.
Essential element of all emergencies.
9.
The second ‘E’ in the HELPERR mnemonic.
Find out more
Below is a list of things you can find out about to enhance your knowledge of the issues and topics covered in this chapter. Make notes using the chapter content, the references and further reading identified, local policies and guidelines and discussions with colleagues.What are the normal ranges for pulse, blood pressure and respiratory rate in pregnancy?What is the mechanism of shock?Check the resuscitation equipment for adults in your clinical area and familiarise yourself with the equipment and emergency drugs.Find out what the local guidelines and policies are for the management ofpre-eclampsia, ante-partum haemorrhage, post-partum haemorrhage, shoulder dystocia and thromboembolism.370
Glossary of terms
Advanced life support
Involves measures such as endotracheal intubation, intravenous can- nulation and fluid resuscitation and drug therapy which in addition to basic life support measures are aimed at resuscitating a patient in cardiac arrest.
Antepartum haemorrhage (APH)
Bleeding from the genital tract from 24 weeks gestation and before the birth of the baby.
Assessment
Thorough physical assessment relevant to the stage in pregnancy, labour or post- natal period to diagnose any deviations from normal. This should include vital signs such as pulse, temperature, blood pressure and respiratory rate and a thorough history. A written record of each assessment is essential for informing the next one.
Basic life support
Combination of rescue breaths and chest compressions necessary to maintain some circulation following cardiac arrest until more advanced methods can be instituted.