Trauma in Pregnancy. Julie Kruithof, MSN, RN, CCRN Adult Critical Care Nurse Educator April, 2014 No disclosures

Size: px
Start display at page:

Download "Trauma in Pregnancy. Julie Kruithof, MSN, RN, CCRN Adult Critical Care Nurse Educator April, 2014 No disclosures"

Transcription

1

2 Trauma in Pregnancy Julie Kruithof, MSN, RN, CCRN Adult Critical Care Nurse Educator April, 2014 No disclosures 2

3 Objectives Discuss epidemiologic and physiologic considerations related to trauma during pregnancy. Describe care management priorities for the pregnant trauma patient. 3

4 4

5 Epidemiology 5 Trauma is estimated to complicate 1 in 12 pregnancies Leading non-obstetrical cause of maternal death Rate of fetal death from maternal trauma 2.3 per 100,000 live births Increase incidence of: Spontaneous abortion Premature rupture of membranes Preterm birth Uterine rupture Cesarean delivery Placental abruption Stillbirth

6 Mechanisms of Injury 6

7 Mechanisms of Injury: Motor Vehicle Crash 7 Most common form of unintentional trauma 87% of pregnant women involved receive some sort of medical care Majority of admissions occur after 20 weeks gestation Major risk factors Improper seatbelt use Use of intoxicants Placental abruption in up to 40% of severely injured cases

8 Mechanisms of Injury: Slips and Falls Predisposed Approximately 25% will fall at least once while 8 pregnant Majority indoors, 39% falling from stairs Risks Preterm labor (4.4x) Placental abruption (8x) Fetal distress (2.1x) Fetal hypoxia (2.9x)

9 Mechanisms of Injury: Burns Thermal, chemical or electrical Impact depends on extent and severity Mortality increases significantly with smoke inhalation Best chance for fetal survival is maternal survival 9

10 Mechanisms of Injury: Domestic Violence Most common form of intentional trauma Risk Factors Maternal or partner substance abuse Low maternal educational level Low socioeconomic status Unintended pregnancy History prior to pregnancy History of witnessed violence as a child Unmarried status Adverse outcomes Spontaneous abortion Neonatal ICU admission Preterm birth Low birth weight 10

11 Mechanisms of Injury: Penetrating Trauma Examples Guns Knives Compared to blunt trauma, increased Fetal mortality Hospital stay Complications 11

12 Mechanisms of Injury 12

13 Incidence / Prevalence Mechanism of Injury Estimated Incidence / Prevalence in Pregnancy Estimated Incidence / Prevalence outside of Pregnancy Domestic violence 8,307 / 100,000 live births 5,239 / 100,000 women Motor vehicle crash 207 / 100,000 live births 1,104 / 100,000 women Falls and slips 48 / 100,000 live births 2,029 / 100,000 women Toxic exposure 25.8 / 100,000 personyears / 100,000 personyears Penetrating trauma 3.27 / 100,00 live births 3.4 / 100,000 women 13 Mendez-Figueroa, H., Dahlke,J., Vrees, R & Rouse, D. (2013) Trauma in Pregnancy: An updated systematic review.

14 Management Stabilize the mother Consider normal physiologic alterations Appropriate center Timely and thorough trauma evaluation Manage life-threatening injuries 14

15 Cardiovascular Considerations Consider physiologic alterations Hypervolemic Tachycardic Low-resistance state Hypercoagulable Uterine displacement Severe hemorrhage: Plasma, platelets and RBC 1:1:1 15 Circ.ahajournals.org

16 Pulmonary Considerations Consider physiologic alterations Normal respiratory alkalosis Diaphragmatic elevation Diminished oxygen reserves Less able to compensate for acidemia Hyperemic mucosa Higher risk of aspiration Thoracic tube placement alterations 1-2 intercostal spaces above usual landmarks 16

17 Abdominal Considerations Consider physiologic alterations Mucosal hyperemia Gastroesophageal mechanism incompetence Delayed gastric emptying Abdominal organ displacement Pelvic vascular engorgement Peritoneal lavage Open recommended No pregnancy specific criteria 17

18 Neurologic Considerations Consider physiologic alterations Spinal cord injury Above T10 unable to feel uterine contractions Severe brain injury and/or brain death 18

19 Radiologic Studies Diagnostic Study Estimated Fetal Absorption (rad) Chest X-Ray Less than Skull X-Ray Less than Pelvic x-ray Lumbar Spine X-Ray 0.6 Abdominal CT Scan Pelvic CT Scan Groen, R; Bae, J; Lim, K. (2012). Fear of the unknown: ionizing radiation exposure during pregnancy. Doi: /j.ajog

20 Ultrasound Ultrasound Evaluation Gestational age Placental location Fetal presentation Viability FAST Exam Fairly equal sensitivity and specificity 20

21 Fetal Surveillance Continuous monitoring Range of 4-48 hours Minimum of 2-6 hours post-trauma Placental Abruption Immediate to 5 days post traumatic insult Not reported when <1 contraction is present in any 10 minute interval over a 4-hour period 21

22 Perimortem Cesarean Section Survival dependent upon: Interval between maternal cardiac arrest and delivery Underlying etiology Location of the arrest Expertise of the team Most likely appropriate Imminent maternal death Within 4 minutes of CPR that has failed to revive the mother 22

23 Primary & Secondary Survey PRIMARY SURVEY Airway Breathing Circulation Uterine displacement KB test to determine dose of Rh immune globulin Disability Exposure SECONDARY SURVEY Allergies Medication Past medical illness / pregnancy Vaginal examination Ultrasound evaluation Abdominal assessment Foley catheter Rectal exam Last meal Events / environment

24 Summary Minor trauma... Limited assessments required Major determinant of outcomes is severity of injury Domestic violence and motor vehicle crashes most common mechanisms Substance abuse is a common accompaniment Stabilize mother first... Fetal stability often follows 24

25 25

26 Selected Sources American Heart Association (2010). ACLS Provider Manual. American Heart Association. Groen, R; Bae, J; Lim, K. (2012). Fear of the unknown: ionizing radiation exposure during pregnancy. Doi: /j.ajog Mendez-Figueroa, H., Dahlke, J., Vrees, R & Rouse, D. (2013) Trauma in Pregnancy: An updated systematic review. Urden, L., Stacy, K., Lough, M. (Eds). (2014). Critical Care Nursing Diagnosis and Management, 7 th Edition. St. Louis: Mosby. 26

27

TRAUMA IN PREGNANCY MODULE

TRAUMA IN PREGNANCY MODULE TRAUMA IN PREGNANCY MODULE INTRODUCTION Trauma affects approximately 7% of pregnancies which approaches rates in the general population. 1 Premature labour, placental abruption, foeto-maternal haemorrhage

More information

Trauma and Pregnancy. William Schecter, MD

Trauma and Pregnancy. William Schecter, MD Trauma and Pregnancy William Schecter, MD Trauma and Pregnancy ATLS Protocol the same Physiologic and Anatomic changes of pregnancy change the pattern of injury and the physiologic response to injury Two

More information

Management of the Pregnant Trauma Patient

Management of the Pregnant Trauma Patient Management of the Pregnant Trauma Patient Yasser Y. El-Sayed, M.D. Associate Professor and Associate Chief Maternal-Fetal Medicine and Obstetrics Stanford University Trauma in Pregnancy Historical Perspective

More information

MANAGING THE PREGNANT TRAUMA PATIENT ALAN H. TYROCH, MD, FACS, FCCM PROFESSOR & CHAIR OF SURGERY TRAUMA MEDICAL DIRECTOR

MANAGING THE PREGNANT TRAUMA PATIENT ALAN H. TYROCH, MD, FACS, FCCM PROFESSOR & CHAIR OF SURGERY TRAUMA MEDICAL DIRECTOR MANAGING THE PREGNANT TRAUMA PATIENT ALAN H. TYROCH, MD, FACS, FCCM PROFESSOR & CHAIR OF SURGERY TRAUMA MEDICAL DIRECTOR INTRODUCTION Trauma impacts 1 in 12 pregnancies Trauma is one of the primary cause

More information

Trauma During Pregnancy. Mary Beth Voights, APN, TNS Carle Foundation Hospital; Urbana, IL

Trauma During Pregnancy. Mary Beth Voights, APN, TNS Carle Foundation Hospital; Urbana, IL Trauma During Pregnancy Mary Beth Voights, APN, TNS Carle Foundation Hospital; Urbana, IL Incidence 6-7% of all pregnant women #1 cause of death in women of child bearing age What % of all trauma pts?

More information

What is ACLS Maternal Focus?

What is ACLS Maternal Focus? Carla Rider, MBA, BSN, RNC-LRN, Administrative Director Women s Services Meredith Green, MSN Candidate, BSN, RN, Clinical Educator Women s Services What is? ACLS Component 1 American Heart Association

More information

The Pregnant Trauma Patient. Shelora Mangan DNP, CNS, RNC-OB Perinatal Clinical Nurse Specialist Legacy Health Women and Newborn Services

The Pregnant Trauma Patient. Shelora Mangan DNP, CNS, RNC-OB Perinatal Clinical Nurse Specialist Legacy Health Women and Newborn Services The Pregnant Trauma Patient Shelora Mangan DNP, CNS, RNC-OB Perinatal Clinical Nurse Specialist Legacy Health Women and Newborn Services Trauma in Pregnancy: Significance Although most injuries during

More information

Why is prematurity a concern?

Why is prematurity a concern? Prematurity What is prematurity? A baby born before 37 weeks of pregnancy is considered premature. Approximately 12% of all babies are born prematurely. Terms that refer to premature babies are preterm

More information

Brenda Chagolla RN, MSN, CNS Manager University Birthing Suites, Women s Pavilion UC Davis Medical Center

Brenda Chagolla RN, MSN, CNS Manager University Birthing Suites, Women s Pavilion UC Davis Medical Center John P. Keats, MD Assistant Clinical Professor of OB/GYN The David Geffen School of Medicine at UCLA Market Medical Executive, Cigna Health Care John.Keats@Cigna.com Brenda Chagolla RN, MSN, CNS Manager

More information

Guidelines and Protocols

Guidelines and Protocols TITLE: TRAUMA TEAM ROLES / RESPONSIBILITIES PURPOSE: A trauma team is a group of specially trained health care professionals organized to provide care to the trauma patient in a coordinated and timely

More information

OET: Listening Part A: Influenza

OET: Listening Part A: Influenza Listening Test Part B Time allowed: 23 minutes In this part, you will hear a talk on critical illnesses due to A/H1N1 influenza in pregnant and postpartum women, given by a medical researcher. You will

More information

Dispatch. Call 1830. EMS 1834

Dispatch. Call 1830. EMS 1834 Obstetric Trauma Dispatch Call received @ 1830 19 y/o 6 months pregnant female punched & kicked in head, chest and abdomen by boyfriend C/O mid chest & abdominal pain EMS enroute @ 1834 Victim # 1 Scene

More information

Overview. Geriatric Overview. Chapter 26. Geriatrics 9/11/2012

Overview. Geriatric Overview. Chapter 26. Geriatrics 9/11/2012 Chapter 26 Geriatrics Slide 1 Overview Trauma Common Medical Emergencies Special Considerations in the Elderly Medication Considerations Abuse and Neglect Expanding the Role of EMS Slide 2 Geriatric Overview

More information

Caring for Mom and Child: Trauma in the Pregnant Patient

Caring for Mom and Child: Trauma in the Pregnant Patient Caring for Mom and Child: Trauma in the Pregnant Patient George Koenig DO, FACS Assistant Professor of Surgery, Division of Trauma & Critical Care Associate Medical Director JeffSTAT Thomas Jefferson University

More information

Lisa Schwing, RN Trauma Program Manager Dayton Children s

Lisa Schwing, RN Trauma Program Manager Dayton Children s Little Kids in Big Crashes The Bio-mechanics of Kids in Car Crashes Lisa Schwing, RN Trauma Program Manager Dayton Children s Very Little Research There has been very little research on the forces a crash

More information

Pennsylvania Trauma Nursing Core Curriculum. Posted to PTSF Website: 10/30/2014

Pennsylvania Trauma Nursing Core Curriculum. Posted to PTSF Website: 10/30/2014 Pennsylvania Trauma Nursing Core Curriculum Posted to PTSF Website: 10/30/2014 PREFACE Care of the trauma patient has evolved since 1985, when the Pennsylvania Trauma Systems Foundation (PTSF) Board of

More information

Influence of Emergency Medical Services on Outcome at Trauma Center. Prehospital Airway Management: Intubation, Devices, and Controversies

Influence of Emergency Medical Services on Outcome at Trauma Center. Prehospital Airway Management: Intubation, Devices, and Controversies Table of Contents: PART I. TRAUMA SYSTEMS Development of Trauma Systems Trauma Center Organization and Verification Injury Severity Scoring: Its Definition and Practical Application Role of Alcohol and

More information

2.17 MANAGEMENT FOLLOWING ABDOMINAL TRAUMA

2.17 MANAGEMENT FOLLOWING ABDOMINAL TRAUMA WOMEN AND NEWBORN HEALTH SERVICE CLINICAL GUIDELINES SECTION B: OBSTETRICS AND MIDWIFERY GUIDELINES 2 COMPLICATIONS OF THE PREGNANCY Authorised by: OGCCU 2.17 MANAGEMENT FOLLOWING ABDOMINAL TRAUMA BACKGROUND

More information

SARASOTA MEMORIAL HOSPITAL NURSING PROCEDURE

SARASOTA MEMORIAL HOSPITAL NURSING PROCEDURE SARASOTA MEMORIAL HOSPITAL NURSING PROCEDURE TITLE: MAGNESIUM SULFATE ADMINISTRATION FOR ANTEPARTUM AND INTRAPARTUM PATIENTS WITH PRE-TERM LABOR DATE: REVIEWED: PAGES: 6/92 08/11 1 of 6 ISSUED FOR: Nursing

More information

ABORTION. Making. Decision

ABORTION. Making. Decision ABORTION Making Decision T h i s p u b l i c a t i o n w a s p r o d u c e d i n c o m p l i a n c e w i t h R. S. 40:1299.35.6 (ACT 648, 1995). The Louisiana Department of Health and Hospitals acknowledges

More information

State Trauma Guidelines for the Management of Injured Pregnant Women

State Trauma Guidelines for the Management of Injured Pregnant Women State Trauma Guidelines for the Management of Injured Pregnant Women IMPORTANT PLEASE READ THIS FIRST: All Patients with Major Trauma or the potential for major trauma* should be transferred to the Adult

More information

Rural Health Advisory Committee s Rural Obstetric Services Work Group

Rural Health Advisory Committee s Rural Obstetric Services Work Group Rural Health Advisory Committee s Rural Obstetric Services Work Group March 15 th webinar topic: Rural Obstetric Patient and Community Issues Audio: 888-742-5095, conference code 6054760826 Rural Obstetric

More information

9/10/2015 CARING FOR TWO: THE PREGNANT TRAUMA PATIENT OBJECTIVES TO REVIEW

9/10/2015 CARING FOR TWO: THE PREGNANT TRAUMA PATIENT OBJECTIVES TO REVIEW UW MEDICINE TITLE OR EVENT CARING FOR TWO: THE PREGNANT TRAUMA PATIENT SUSAN D. REED, MD, MPH PROFESSOR OB/GYN; ADJUNCT EPIDEMIOLOGY OBJECTIVES TO REVIEW Epidemiology/outcomes Pregnancy physiology Evaluation

More information

Diagnostic Radiology and Pregnancy

Diagnostic Radiology and Pregnancy Policy Library Version: November 2005 Approved by: Council Date of approval: November 2005 1. SCOPE This document discusses the effects of radiation on the fetus, and then provides some guidance to radiologists

More information

Emergency Medical Resuscitation in Pregnancy with Trauma

Emergency Medical Resuscitation in Pregnancy with Trauma CHAPTER 6 Emergency Medical Resuscitation in Pregnancy with Trauma T. Campbell, S. Galwankar Introduction Trauma is currently the most common non-obstetric cause of morbidity and mortality during pregnancy.

More information

Early evaluation of the abdomen is a challenging component of the initial assessment of the

Early evaluation of the abdomen is a challenging component of the initial assessment of the Focused Issue of This Month Emergency Care of Abdominal Trauma Kyoung Soo Lim, MD Department of Emergency Medicine, Ulsan University of College of Medicine Email : kslim@amc.seoul.kr J Korean Med Assoc

More information

Trauma in the Pregnant Female. Luanna Beauchamp, MD, FACOG

Trauma in the Pregnant Female. Luanna Beauchamp, MD, FACOG Trauma in the Pregnant Female Luanna Beauchamp, MD, FACOG Introduction Save the mother, save the fetus The Scenario O The situation: It s Friday night, and as the EMS provider on call, you receive a call.

More information

Oxygen Therapy. Oxygen therapy quick guide V3 July 2012.

Oxygen Therapy. Oxygen therapy quick guide V3 July 2012. PRESENTATION Oxygen (O 2 ) is a gas provided in a compressed form in a cylinder. It is also available in a liquid form. It is fed via a regulator and flow meter to the patient by means of plastic tubing

More information

Aehlert: Paramedic Practice Today PowerPoint Lecture Notes Chapter 50: Abdominal Trauma

Aehlert: Paramedic Practice Today PowerPoint Lecture Notes Chapter 50: Abdominal Trauma Aehlert: Paramedic Practice Today PowerPoint Lecture Notes Chapter 50: Abdominal Trauma Chapter 50 Abdominal Trauma 1 Describe the epidemiology, including morbidity, mortality rates, and prevention strategies,

More information

RISK FOR INFECTION IN THE LATE PRETERM INFANT

RISK FOR INFECTION IN THE LATE PRETERM INFANT RISK FOR INFECTION IN THE LATE PRETERM INFANT Late preterm infants are at greater risk of having an infection caused by bacteria. An infection in the uterine environment is sometimes the reason for early

More information

Objective of This Lecture

Objective of This Lecture Component 2: The Culture of Health Care Unit 3: Health Care Settings The Places Where Care Is Delivered Lecture 5 This material was developed by Oregon Health & Science University, funded by the Department

More information

SARASOTA MEMORIAL HOSPITAL NURSING DEPARTMENT POLICY

SARASOTA MEMORIAL HOSPITAL NURSING DEPARTMENT POLICY SARASOTA MEMORIAL HOSPITAL NURSING DEPARTMENT POLICY TITLE: ADMISSION/DISCHARGE/ TRANSFER : EFFECTIVE DATE: REVISED DATE: POLICY TYPE: (Maternal) 11/84 7/15 DEPARTMENTAL INTERDEPARTMENTAL DEPARTMENTS PROVIDING

More information

Newborn outcomes after cesarean section for fetal distress in BC

Newborn outcomes after cesarean section for fetal distress in BC Newborn outcomes after cesarean section for fetal distress in BC Patricia Janssen, PhD, UBC School of Population and Public Health Scientist, Child and Family Research Institute Kevin Jenniskens, MSc,

More information

WHAT YOU SHOULD KNOW ABOUT HDN. Provided by Grifols

WHAT YOU SHOULD KNOW ABOUT HDN. Provided by Grifols WHAT YOU SHOULD KNOW ABOUT HDN Provided by Grifols 2 PATIENT QUESTIONS AND ANSWERS What is hemolytic disease of the newborn (HDN)? If your body has produced antibodies to fight the antigens on your baby

More information

KENTUCKY BOARD OF NURSING 312 Whittington Parkway, Suite 300 Louisville, Kentucky 40222-5172 http://kbn.ky.gov ADVISORY OPINION STATEMENT

KENTUCKY BOARD OF NURSING 312 Whittington Parkway, Suite 300 Louisville, Kentucky 40222-5172 http://kbn.ky.gov ADVISORY OPINION STATEMENT (Revised 4/2016) KENTUCKY BOARD OF NURSING 312 Whittington Parkway, Suite 300 Louisville, Kentucky 40222-5172 http://kbn.ky.gov ADVISORY OPINION STATEMENT ROLES OF NURSES IN THE CARE OF PRENATAL AND INTRAPARTUM

More information

BEST EVIDENCE APPROACH TO IMAGING PEDIATRIC BLUNT ABDOMINAL TRAUMA

BEST EVIDENCE APPROACH TO IMAGING PEDIATRIC BLUNT ABDOMINAL TRAUMA BEST EVIDENCE APPROACH TO IMAGING PEDIATRIC BLUNT ABDOMINAL TRAUMA Bryan J. Dicken, MSc, FRCSC, FAAP Associate Professor of Surgery Stollery Children s Hospital Objectives At the completion of this discussion,

More information

Chapter 7. Ideally, educational preparation for childbirth begins prior to conception

Chapter 7. Ideally, educational preparation for childbirth begins prior to conception Chapter 7 Nursing Management of Pain During Labor and Birth Key Terms Cleansing breath Effleurage Endorphins Pain threshold Focal point Pain tolerance Education for Childbearing Ideally, educational preparation

More information

acbis Chapter 1: Overview of Brain Injury

acbis Chapter 1: Overview of Brain Injury acbis Academy for the Certification of Brain Injury Specialists Certification Exam Preparation Course Chapter 1: Overview of Brain Injury Module Objectives Describe the incidence, prevalence and epidemiology

More information

Basic ATLS. The Primary Survey. Jason Smith MD DMI FRCS(Gen.Surg) Consultant Surgeon

Basic ATLS. The Primary Survey. Jason Smith MD DMI FRCS(Gen.Surg) Consultant Surgeon Basic ATLS The Primary Survey Jason Smith MD DMI FRCS(Gen.Surg) Consultant Surgeon Trauma - expression comprising a spectrum of severity of mechanical violation of tissues, from a little scratch to a multiply

More information

Fractures of the Thoracic and Lumbar Spine

Fractures of the Thoracic and Lumbar Spine Copyright 2010 American Academy of Orthopaedic Surgeons A spinal fracture is a serious injury. Fractures of the Thoracic and Lumbar Spine The most common fractures of the spine occur in the thoracic (midback)

More information

9.5 Fetal and Infant Deaths

9.5 Fetal and Infant Deaths 9.5 Fetal and Infant 9.5.1 Fetal Between 2001 and 2005, there were 24 fetal on average per year in Kalamazoo County. Fetal mortality rates are calculated by dividing the number of fetal in a time period

More information

Sign up to receive ATOTW weekly -

Sign up to receive ATOTW weekly - MANAGEMENT OF TRAUMA IN PREGNANCY ANAESTHESIA TUTORIAL OF THE WEEK 172 1 ST MARCH 2010 Mario Fernandes Specialist Registrar in Anaesthesia Ninewells Hospital, Dundee, United Kingdom. Correspondence to

More information

Oxygen - update April 2009 OXG

Oxygen - update April 2009 OXG PRESENTATION Oxygen (O 2 ) is a gas provided in compressed form in a cylinder. It is also available in liquid form, in a system adapted for ambulance use. It is fed via a regulator and flow meter to the

More information

STATE OF MAINE DEPARTMENT OF PUBLIC SAFETY MAINE EMERGENCY MEDICAL SERVICES 152 STATE HOUSE STATION AUGUSTA, MAINE 04333

STATE OF MAINE DEPARTMENT OF PUBLIC SAFETY MAINE EMERGENCY MEDICAL SERVICES 152 STATE HOUSE STATION AUGUSTA, MAINE 04333 STATE OF MAINE DEPARTMENT OF PUBLIC SAFETY MAINE EMERGENCY MEDICAL SERVICES 152 STATE HOUSE STATION AUGUSTA, MAINE 04333 PAUL R. LEPAGE GOVERNOR JOHN E. MORRIS COMMISSIONER SHAUN A. ST. GERMAIN DIRECTOR

More information

a. General Rules for Obstetric Cases

a. General Rules for Obstetric Cases 15. Chapter 15: Pregnancy, Childbirth, and the Puerperium (O00-O9A) a. General Rules for Obstetric Cases 1) Codes from chapter 15 and sequencing priority Obstetric cases require codes from chapter 15,

More information

St George/Sutherland Hospitals And Health Services

St George/Sutherland Hospitals And Health Services TRAUMA - MANAGEMENT OF THE PREGNANT TRAUMA PATIENT - SGH Cross references Nil (including NSW Health/ SESIAHS policy directives) 1. What it is Evidence-based recommendations for the management of pregnant

More information

Cord Blood Erythropoietin and Markers of Fetal Hypoxia

Cord Blood Erythropoietin and Markers of Fetal Hypoxia July 21, 2011 By NeedsFixing [1] To investigating the relationship between cord blood erythropoietin and clinical markers of fetal hypoxia. Abstract Objective: To investigating the relationship between

More information

Chapter 5. Chapter 5. BMT Survivor. This chapter is key in helping you prepare for your transplant. Preparing for Your Transplant

Chapter 5. Chapter 5. BMT Survivor. This chapter is key in helping you prepare for your transplant. Preparing for Your Transplant This chapter is key in helping you prepare for your transplant. BMT Survivor Chapter 5 Preparing for Your Transplant Evaluation Tests for Eligibility, Preadmission Central Vascular Access Device Fertility

More information

The Abbreviated Injury Scale (AIS) A brief introduction

The Abbreviated Injury Scale (AIS) A brief introduction The Abbreviated Injury Scale (AIS) A brief introduction Abbreviated Injury Scale 1990 Revision Update 98 The Abbreviated Injury Scale produced by: Association for the Advancement of Automotive Medicine

More information

Omega-3 fatty acids improve the diagnosis-related clinical outcome. Critical Care Medicine April 2006;34(4):972-9

Omega-3 fatty acids improve the diagnosis-related clinical outcome. Critical Care Medicine April 2006;34(4):972-9 Omega-3 fatty acids improve the diagnosis-related clinical outcome 1 Critical Care Medicine April 2006;34(4):972-9 Volume 34(4), April 2006, pp 972-979 Heller, Axel R. MD, PhD; Rössler, Susann; Litz, Rainer

More information

EMSPIC State NEMSIS Datasets

EMSPIC State NEMSIS Datasets E01_01 Patient Care Report Number X X E01_02 Software Creator X X E01_03 Software Name X X E01_04 Sofware Version X X E02_01 EMS Agency Number X X E02_02 Incident Number X E02_03 EMS Unit (Vehicle) Response

More information

IMAGING PROCEDURES REQUIRING PRECERTIFICATION

IMAGING PROCEDURES REQUIRING PRECERTIFICATION IMAGING PROCEDURES REQUIRING PRECERTIFICATION Below is a list of the imaging CPT codes that require precertification for commercial and Medicare Members. Please note that other procedures may be added

More information

Olmsted County, Minnesota Maternal and Child Health Annual Report THE CURRENT CONDITION OF MATERNAL AND CHILD HEALTH IN OLMSTED COUNTY

Olmsted County, Minnesota Maternal and Child Health Annual Report THE CURRENT CONDITION OF MATERNAL AND CHILD HEALTH IN OLMSTED COUNTY , Minnesota Maternal and Child Health Annual Report 29-213 THE CURRENT CONDITION OF MATERNAL AND CHILD HEALTH IN OLMSTED COUNTY Population Report This page intentionally left blank 2 , Minnesota Maternal

More information

TRAUMA SURGERY Dr. Michal Cheatham Orlando Regional Health PGY-4

TRAUMA SURGERY Dr. Michal Cheatham Orlando Regional Health PGY-4 ROTATION LIAISON: INSTITUTION: LEVEL(S): TRAUMA SURGERY Dr. Michal Cheatham Orlando Regional Health PGY-4 I. GENERAL INFORMATION The General Surgery Department at Orlando Regional Health has three full

More information

Cardiovascular Disease and Maternal Mortality what do we know and what are the key questions?

Cardiovascular Disease and Maternal Mortality what do we know and what are the key questions? Cardiovascular Disease and Maternal Mortality what do we know and what are the key questions? AFSHAN HAMEED, MD, FACOG, FACC Associate Clinical Professor Maternal Fetal Medicine and Cardiology University

More information

K: Maternal / Newborn Care

K: Maternal / Newborn Care K: Maternal / Newborn Care Alberta Licensed Practical Nurses Competency Profile 103 Competency: K-1 Prenatal Care, Assessment and Teaching K-1-1 K-1-2 K-1-3 Demonstrate knowledge of human anatomy and physiology

More information

STATEMENT OF PRINCIPLES: TRAUMA ANESTHESIOLOGY

STATEMENT OF PRINCIPLES: TRAUMA ANESTHESIOLOGY STATEMENT OF PRINCIPLES: TRAUMA ANESTHESIOLOGY Introduction (Approved by the ASA House of Delegates on October 16, 2013) Trauma is a serious bodily injury or shock caused by an external source. Trauma

More information

Mary Ann Contreras RN Injury Prevention/Trauma Outreach Coordinator JPS Health Network

Mary Ann Contreras RN Injury Prevention/Trauma Outreach Coordinator JPS Health Network Mary Ann Contreras RN Injury Prevention/Trauma Outreach Coordinator JPS Health Network Objectives Comprehend that interpersonal violence is a public health problem and recognize two examples of the effects

More information

The ABCDE S to Envisioning a Healthy Future. A Guide to Preconception Health

The ABCDE S to Envisioning a Healthy Future. A Guide to Preconception Health The ABCDE S to Envisioning a Healthy Future A Guide to Preconception Health Developing Healthy Lifestyles is Important Because 49% of Pregnancies are Unplanned A woman s health and the health of her infant

More information

Geisinger Health System Anesthesiology Residency Program. Obstetric Anesthesia

Geisinger Health System Anesthesiology Residency Program. Obstetric Anesthesia Geisinger Health System Anesthesiology Residency Program Obstetric Anesthesia INTRODUCTION Education and training in obstetric anesthesia will consist of attending-supervised rotations for four weeks during

More information

Neural Tube Defects - NTDs

Neural Tube Defects - NTDs Neural Tube Defects - NTDs Introduction Neural tube defects are also known as NTDs. They happen when the spine and brain do not fully develop while the fetus is forming in the uterus. Worldwide, there

More information

X-ray (Radiography), Bone

X-ray (Radiography), Bone X-ray (Radiography), Bone What is Bone X-ray (Radiography)? An x-ray (radiograph) is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Imaging with x-rays involves

More information

Tim Erskine Chief, Trauma Systems and Research Ohio Department of Public Safety

Tim Erskine Chief, Trauma Systems and Research Ohio Department of Public Safety Tim Erskine Chief, Trauma Systems and Research Ohio Department of Public Safety » Describe Ohio s legal definition of trauma» List the anatomic and physiologic criteria to be used by when evaluating adult,

More information

Electrical Burns 新 光 急 診 張 志 華

Electrical Burns 新 光 急 診 張 志 華 Electrical Burns 新 光 急 診 張 志 華 Electrical Burns Definition Cellular damage due to electrical current High vs. low tension injuries 1,000 Volts dividing line Electrical Burns - Pathophysiology Joule Effect:

More information

Obstetric Data Definitions Issues and Rationale for Change DELIVERY

Obstetric Data Definitions Issues and Rationale for Change DELIVERY Below are the refined definitions, identified issues, and rationale for the language presented in the refined definitions in the Delivery category. This document is intended to provide an overview and

More information

Women's Circle Nurse-Midwife Services Inc. Angela Kreider CNM, MSN 1003 Plumas Street Yuba City, CA 95991 (530)751-2273 FAX (530)751-2274

Women's Circle Nurse-Midwife Services Inc. Angela Kreider CNM, MSN 1003 Plumas Street Yuba City, CA 95991 (530)751-2273 FAX (530)751-2274 Women's Circle Nurse-Midwife Services Inc. Angela Kreider CNM, MSN 1003 Plumas Street Yuba City, CA 95991 (530)751-2273 FAX (530)751-2274 Informed Disclosure and Consent The following consent explains

More information

404 Section 5 Shock and Resuscitation. Scene Size-up. Primary Assessment. History Taking

404 Section 5 Shock and Resuscitation. Scene Size-up. Primary Assessment. History Taking 404 Section 5 and Resuscitation Scene Size-up Scene Safety Mechanism of Injury (MOI)/ Nature of Illness (NOI) Ensure scene safety and address hazards. Standard precautions should include a minimum of gloves

More information

ITLS & PHTLS: A Comparison

ITLS & PHTLS: A Comparison ITLS & PHTLS: A Comparison International Trauma Life Support (ITLS) is a global organization dedicated to preventing death and disability from trauma through education and emergency care. ITLS educates

More information

CHILD PSYCHIATRIC QUESTIONNAIRE

CHILD PSYCHIATRIC QUESTIONNAIRE CHILD PSYCHIATRIC QUESTIONNAIRE Developed by Thomas W. McCormack, M.D. Dear Patients/ Parents/ Caretakers: Please carefully fill in this form prior to your first appointment in order to help us reduce

More information

K: Maternal/ Newborn Care

K: Maternal/ Newborn Care K: Maternal/ Newborn Care College of Licensed Practical Nurses of Alberta, Competency Profile for LPNs, 3rd Ed. 93 Competency: K-1 Maternal/Newborn Nursing K-1-1 K-1-2 K-1-3 Demonstrate knowledge and ability

More information

Cardiac and Pulmonary Issues in the Elite Athlete. Keep Your Edge Hockey Sports Medicine 2015 Toronto August 28-30 2015

Cardiac and Pulmonary Issues in the Elite Athlete. Keep Your Edge Hockey Sports Medicine 2015 Toronto August 28-30 2015 Cardiac and Pulmonary Issues in the Elite Athlete Keep Your Edge Hockey Sports Medicine 2015 Toronto August 28-30 2015 THORACIC EMERGENCIES Hockey related thoracic trauma is blunt Injury to the boney

More information

EMS Patient Care Report Navigation Logic for Record Creation

EMS Patient Care Report Navigation Logic for Record Creation EMS Patient Report Navigation Logic for Record Creation This document serves to provide specifications regarding data entry and data element completion requirements for PreMIS Version 2 web-based application

More information

The Clinical Content of Preconception Care: Alcohol, Tobacco, and Illicit Drug Exposures

The Clinical Content of Preconception Care: Alcohol, Tobacco, and Illicit Drug Exposures The Clinical Content of Preconception Care: Alcohol, Tobacco, and Illicit Drug Exposures by R. Louise Floyd, DSN, RN; Brian W. Jack, MD; Robert Cefalo, MD, PhD; Hani Atrash, MD, MPH; Jeanne Mahoney, BSN,

More information

First Responder (FR) and Emergency Medical Responder (EMR) Progress Log

First Responder (FR) and Emergency Medical Responder (EMR) Progress Log First Responder (FR) and Emergency Medical Responder (EMR) Progress Log Note: Those competencies that are for EMR only are denoted by boldface type. For further details on the National Occupational Competencies

More information

Firefighter Pre-Hospital Care Program Module 18. Chest Assessment And Injuries

Firefighter Pre-Hospital Care Program Module 18. Chest Assessment And Injuries Firefighter Pre-Hospital Care Program Module 18 Chest Assessment And Injuries Firefighter Pre-Hospital Care Program Module 18 At the end of the lesson and upon completion of the post test quiz, the participant

More information

ATLS in Norway. Purpose with Lecture. Olav Røise Medical Director ATLS Norway. To encourage and get radiologists involved in ATLS education

ATLS in Norway. Purpose with Lecture. Olav Røise Medical Director ATLS Norway. To encourage and get radiologists involved in ATLS education ATLS in Norway Olav Røise Medical Director ATLS Norway Purpose with Lecture To encourage and get radiologists involved in ATLS education Framework What is ATLS? History and status The concept Implications

More information

$traight Talk XXIV December 8, 2015

$traight Talk XXIV December 8, 2015 $traight Talk XXIV December 8, 2015 Sandy Steele, CPC, CPMA, CEDC, CAC 1 Ultrasound and Ultrasound Assisted Procedures Documentation Requirements Indication medical necessity: The record must indicate

More information

(a) Glasgow coma scale less than or equal to thirteen; (b) Loss of consciousness greater than five minutes;

(a) Glasgow coma scale less than or equal to thirteen; (b) Loss of consciousness greater than five minutes; ACTION: Original DATE: 09/11/2014 3:19 PM 4765-14-02 Determination of a trauma victim. Emergency medical service personnel shall use the criteria in this rule, consistent with their certification, to evaluate

More information

THORACIC AND ABDOMINAL INJURIES. Dr. Szebeny Miklós SE Traumatologia Tanszék

THORACIC AND ABDOMINAL INJURIES. Dr. Szebeny Miklós SE Traumatologia Tanszék THORACIC AND ABDOMINAL INJURIES Dr. Szebeny Miklós SE Traumatologia Tanszék Andrew B.Peitzman: The Trauma Manual: Trauma and Acute Care Surgery (Lippincott Williams & Wilkins : at LWW.com) Chapter 24 25

More information

Lightning Strike Injuries. Lightning strikes are one of the top three cause of death associated with a natural or environmental phenomenon

Lightning Strike Injuries. Lightning strikes are one of the top three cause of death associated with a natural or environmental phenomenon Lightning Strike Injuries Lightning strikes are one of the top three cause of death associated with a natural or environmental phenomenon Introduction Lightning is a very dramatic natural phenomenon that

More information

ABSTRACT LABOR AND DELIVERY

ABSTRACT LABOR AND DELIVERY ABSTRACT POLICY Prior to fetal viability, intentionally undertaking delivery of a fetus is the equivalent of abortion and is not permissible. After fetal viability has been reached, intentionally undertaking

More information

Epidemiology 521. Epidemiology of Maternal and Child Health Problems. Winter / Spring, 2010

Epidemiology 521. Epidemiology of Maternal and Child Health Problems. Winter / Spring, 2010 Extended MPH Degree Program School of Public Health Department of Epidemiology University of Washington Epidemiology 521 Epidemiology of Maternal and Child Health Problems Winter / Spring, 2010 Instructor:

More information

There are two types of communications that must be documented in the manner described subsequently:

There are two types of communications that must be documented in the manner described subsequently: Guidelines for Documentation of Special Verbally Communicated Imaging Findings these guidelines in no way supersede the official hospital policy (also posted in conjunction with this document) in this

More information

Trauma in Pregnancy. Ob Hospitalist Group

Trauma in Pregnancy. Ob Hospitalist Group Trauma in Pregnancy Ob Hospitalist Group Background Trauma impacts 5-9% of all pregnancies Trauma is the leading cause of non-obstetric maternal mortality in the United States Causes 46% of maternal deaths

More information

Premature Infant Care

Premature Infant Care Premature Infant Care Introduction A premature baby is born before the 37th week of pregnancy. Premature babies are also called preemies. Premature babies may have health problems because their organs

More information

Developing Human Fetus

Developing Human Fetus Period Date LAB. DEVELOPMENT OF A HUMAN FETUS After a human egg is fertilized with human sperm, the most amazing changes happen that allow a baby to develop. This amazing process, called development, normally

More information

Simulation Design Template

Simulation Design Template Simulation Design Template Date: May 7, 2008 Discipline: Expected Simulation Run Time: 20 mins Location: hospital ER Admission Date: Today s Date: Brief Description of Client Name: Mr. Crash Gender: M

More information

Trauma Audit & Research Network. CORE Screens user guide

Trauma Audit & Research Network. CORE Screens user guide Trauma Audit & Research Network CORE Screens user guide Launched January 2011 BACKGROUND From January 2011 onwards the TARN Electronic Data Collection & Reporting (edcr) system will allow users to choose

More information

January-February 2008 Volume 27 Number 1. Case Study Peer Reviewed Perimortem cesarean section in the helicopter EMS setting: A case report

January-February 2008 Volume 27 Number 1. Case Study Peer Reviewed Perimortem cesarean section in the helicopter EMS setting: A case report January-February 2008 Volume 27 Number 1 Case Study Peer Reviewed Perimortem cesarean section in the helicopter EMS setting: A case report http://www2.us.elsevierhealth.com/inst/serve?retrieve=pii/s1067-991x(07)00164-2&arttype=full#head1

More information

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. EPC, Ch 26 Quiz w-key Name MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question. 1) The largest reserve of blood of any body organ is contained in the:

More information

35-40% of GBS disease occurs in the elderly or in adults with chronic medical conditions.

35-40% of GBS disease occurs in the elderly or in adults with chronic medical conditions. What is Group B Strep (GBS)? Group B Streptococcus (GBS) is a type of bacteria that is found in the lower intestine of 10-35% of all healthy adults and in the vagina and/or lower intestine of 10-35% of

More information

Nursing. Management of Spinal Trauma. Content. Objectives. Objectives

Nursing. Management of Spinal Trauma. Content. Objectives. Objectives 7 cervical vertebrae Content 12 thoracic vertebrae Nursing 5 sacral vertebrae Management of Spinal Trauma Kwai Fung Betty Siu Ward Manager O&T Dept TKOH Date : 22nd April 2007 5 lumbar vertebrae 4 coccygeal

More information

Study Period: Start of intravenous (IV) systemic lupus erythematosus (SLE) Phase 2 clinical trials up to 08MAR2014

Study Period: Start of intravenous (IV) systemic lupus erythematosus (SLE) Phase 2 clinical trials up to 08MAR2014 The study listed may include approved and non-approved uses, formulations or treatment regimens. The results reported in any single study may not reflect the overall results obtained on studies of a product.

More information

Vaginal Birth After Cesarean and Planned Repeat Cesarean Birth

Vaginal Birth After Cesarean and Planned Repeat Cesarean Birth More Information PATIENT INFORMATION BOOKLET The website of the Best Birth Clinic has links to more resources and information on VBAC and repeat cesarean: www.powertopush.ca This booklet was produced by

More information

CT Dose Measures. Marilyn J. Siegel, M.D Mallinckrodt Institute of Radiology Washington University Medical Center St. Louis, MO

CT Dose Measures. Marilyn J. Siegel, M.D Mallinckrodt Institute of Radiology Washington University Medical Center St. Louis, MO CT Dose Measures Marilyn J. Siegel, M.D Mallinckrodt Institute of Radiology Washington University Medical Center St. Louis, MO Disclosure of Commercial Interest I have a financial relationship with a commercial

More information

Chapter 01: Introduction to Nursing Care of Children Test Bank

Chapter 01: Introduction to Nursing Care of Children Test Bank Chapter 01: Introduction to Nursing Care of Children Test Bank MULTIPLE CHOICE 1. A nurse is reviewing changes in healthcare delivery and funding for pediatric populations. Which current trend in the pediatric

More information

CORE INFO: Head and spinal injuries in children

CORE INFO: Head and spinal injuries in children CORE INFO: Head and spinal injuries in children Introduction This leaflet summarises what is currently known about the clinical presentation of abusive head trauma (AHT) and spinal injuries in children.

More information

ADULT PSYCHIATRIC QUESTIONNAIRE

ADULT PSYCHIATRIC QUESTIONNAIRE ADULT PSYCHIATRIC QUESTIONNAIRE Developed by Thomas W. McCormack, M.D. Dear Patients: Please carefully fill in this form prior to your first appointment in order to help us reduce the time and cost of

More information

Pharmacy. IV Therapy. Medical/Surgical Supplies and Devices

Pharmacy. IV Therapy. Medical/Surgical Supplies and Devices 26.3.2.2 Revenue s (Outpatient Hospital) HCFA-1450 (UB-92) revenue codes must be used to bill outpatient hospital facility services. In some instances, a HCPCS procedure code is required in addition to

More information

CLINICAL GUIDELINE FOR VAGINAL BIRTH AFTER CAESAREAN SECTION (VBAC)

CLINICAL GUIDELINE FOR VAGINAL BIRTH AFTER CAESAREAN SECTION (VBAC) CLINICAL GUIDELINE FOR VAGINAL BIRTH AFTER CAESAREAN SECTION (VBAC) 1. Aim/Purpose of this Guideline 1.1. Due to a rise in the caesarean section rate there are increasing numbers of pregnant women who

More information