In a prolapsed cord, what steps should EMS take?

In a prolapsed cord, what steps should EMS take?

• A. Cover exposed cord with sterile gauze.
• B. Delay intervention until arrival at hospital.
• C. Place mother with hips elevated on pillows; insert a gloved hand into vagina and gently push presenting part off cord; transport immediately; do not remove hand until relieved by hospital personnel; cover exposed cord with saline-soaked gauze.
• D. Attempt to clamp the cord before the head is delivered.

Answer: (C)

Prolapsed umbilical cord is an obstetric emergency because the exposed cord can be compressed by the presenting part, cutting off blood flow to the fetus. The priority is to relieve that pressure immediately and get mom to a facility quickly. Elevate the mother’s hips to reduce direct pressure on the cord and make space for the presenting part. Then insert a sterile, gloved hand into the vagina and gently lift the presenting part off the cord to relieve compression. Keep that pressure in place during transport until hospital personnel take over. Cover the exposed cord with saline-soaked gauze to keep it moist and protect it from drying, which helps preserve blood flow to the fetus. Do not push the cord back into the uterus and do not delay transport for other measures. Stay with the patient and monitor the status while communicating the obstetric emergency to the receiving facility. This approach directly addresses the immediate issue—cord compression—while ensuring rapid delivery and ongoing protection of the cord, which other options fail to do in combination.

Prolapsed umbilical cord is an obstetric emergency because the exposed cord can be compressed by the presenting part, cutting off blood flow to the fetus. The priority is to relieve that pressure immediately and get mom to a facility quickly.

Elevate the mother’s hips to reduce direct pressure on the cord and make space for the presenting part. Then insert a sterile, gloved hand into the vagina and gently lift the presenting part off the cord to relieve compression. Keep that pressure in place during transport until hospital personnel take over. Cover the exposed cord with saline-soaked gauze to keep it moist and protect it from drying, which helps preserve blood flow to the fetus. Do not push the cord back into the uterus and do not delay transport for other measures. Stay with the patient and monitor the status while communicating the obstetric emergency to the receiving facility.

This approach directly addresses the immediate issue—cord compression—while ensuring rapid delivery and ongoing protection of the cord, which other options fail to do in combination.