If third-trimester bleeding with crowning and pushing and no time for transport, what should EMS do?

If third-trimester bleeding with crowning and pushing and no time for transport, what should EMS do?

• A. Wait for hospital staff to arrive.
• B. Proceed with delivery if crowning and pushing.
• C. Transport immediately despite crowning.
• D. Place mother on her left side and observe.

Answer: (B)

When there is third-trimester bleeding with crowning and pushing and no time to transport, the best action is to proceed with delivery on scene. Crowning and active pushing indicate the baby will be born imminently, and delaying to reach a hospital increases the risk of an uncontrolled birth in an ambulance or on the way there. The EMS role is to assist and facilitate a safe delivery, not to delay care. Support the patient and prepare for delivery: control the perineum to reduce tearing, guide the head as it crowns, and, if needed, gently suction the mouth and nose to clear secretions. Once the head and then the body are delivered, place the newborn on the mother’s chest or beside her to keep warm, dry the baby, and monitor breathing. After delivery, clamping and cutting the umbilical cord should be done per your protocol, and assess for placenta delivery and any excessive bleeding, providing fundal massage if trained. Keep the mother warm and comfortable and continue to monitor both until transport becomes feasible.

When there is third-trimester bleeding with crowning and pushing and no time to transport, the best action is to proceed with delivery on scene. Crowning and active pushing indicate the baby will be born imminently, and delaying to reach a hospital increases the risk of an uncontrolled birth in an ambulance or on the way there. The EMS role is to assist and facilitate a safe delivery, not to delay care.

Support the patient and prepare for delivery: control the perineum to reduce tearing, guide the head as it crowns, and, if needed, gently suction the mouth and nose to clear secretions. Once the head and then the body are delivered, place the newborn on the mother’s chest or beside her to keep warm, dry the baby, and monitor breathing. After delivery, clamping and cutting the umbilical cord should be done per your protocol, and assess for placenta delivery and any excessive bleeding, providing fundal massage if trained. Keep the mother warm and comfortable and continue to monitor both until transport becomes feasible.