Help with Presentation on PRECIPITOUS DELIVERY

Specialties Ob/Gyn

Published

Hi all,

I will be giving a 1 hour presentation at work ( I am an ER RN) on Precipitous delivery since we sometimes get one or two a month. I am very comfortable delivering myself; however a lot of my co-workers are not and have a lot of questions.

I am wondering if anyone knows any web sites that have downloadable videos that I could put into the presentation without requiring a web connection, and preferably free.

Also any tips on what to add...

THanks for any help,

Sweetooth

Specializes in Labor & Delivery.

I in no way intended what I posted to come across as negative. You asked what you should cover when teaching out of hospital deliveries. I just stated what I had obseved when receiving out of hospital deliveries. I said "skin to skin if possible" and also that the papamedics did a great job. I'm unclear as to how that is perceived as negative. I certainly couldn't do your job. I can only do what I know, and you asked for advice. I in no way meant any disrespect!

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Specializes in Labor & Delivery.

Oh also on the skin to skin comment. I was thinking that if mom delivered at home and you were transporting her from there, that she would be placed on the stretcher holding the baby. If she was holding that baby I could be placed against her chest skin to skin. I wasn't thinking about the actual delivery taking place in the back of the ambulance.

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Specializes in ED, Pedi Vasc access, Paramedic serving 6 towns.
And that may be the answer right there! Nursing staff might not be aware of what EMS IS or ISN'T allowed to do. Make sures Rn's are aware of that and they can prepare accordingly (Pit ready to hang, many blankets available/warmer).

Exactly my point, nurses shouldn't be trash talking about EMS professionals when what we are not doing may not be our fault!! Its not our job to make sure your prepared, if you have concerns take some time and look up the EMS protocols in your state or locality with reference to OB emergencies! Do some of your own research. You honestly think we can go visit every hospital in the area that we cover and advise EVERY L and D RN with regards to what we cannot do? Seriously? You guys do not even respect us when we bring you a healthy, warm baby and a mother who is stable and already has a running IV so when the DOCTOR tells you what to do, you can do it quicker!

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Specializes in ED, Pedi Vasc access, Paramedic serving 6 towns.
Oh also on the skin to skin comment. I was thinking that if mom delivered at home and you were transporting her from there, that she would be placed on the stretcher holding the baby. If she was holding that baby I could be placed against her chest skin to skin. I wasn't thinking about the actual delivery taking place in the back of the ambulance.

It doesn't matter where mom is delivering, skin to skin is a no no in the back of an ambulance or while mom is being carried out to the ambulance obviously. We don't hang out long enough in the home to do skin to skin, soon as the baby is out and providing it doesnt require resusitative efforts and mom is stable we are out of there and on the way to the hospital. Your asking someone who may be uncomfortable, who is unfamilar with how much swaying an ambulance does. and is being contantly assessed to focus on holding a baby that could very easily fly right off her chest with one quick stop or turn. We generally will have an EMS person hold the baby since we are familar with the sway of the ambulance and are able to concentrate soley on the baby and keeping him or her secure.

Sweetooth

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Specializes in ED, Pedi Vasc access, Paramedic serving 6 towns.
I in no way intended what I posted to come across as negative. You asked what you should cover when teaching out of hospital deliveries. I just stated what I had obseved when receiving out of hospital deliveries. I said "skin to skin if possible" and also that the papamedics did a great job. I'm unclear as to how that is perceived as negative. I certainly couldn't do your job. I can only do what I know, and you asked for advice. I in no way meant any disrespect!

You could have easily posted the same information whie leaving your obvious disrespect towards EMS providers out of it!!! For example "EMS brough in a pt and the Paramedic stated proudly, "she's hardly even bleeding!" . Sorry, we do not have doctors to assess our patients and tell us what to do like labor and delivery nurses do.

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Specializes in OB.
You could have easily posted the same information whie leaving your obvious disrespect towards EMS providers out of it!!! For example "EMS brough in a pt and the Paramedic stated proudly, "she's hardly even bleeding!" . Sorry, we do not have doctors to assess our patients and tell us what to do like labor and delivery nurses do.

Now you are showing the same disrespect of which you accuse others .

Instead why not lay out some of the conditions under which you work and the problems you encounter (since many are obviously unaware) so that we may help you brainstorm on solutions.

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Specializes in Community, OB, Nursery.

Guys....

Hospital nurses have a hard job. Paramedics and EMTs have a hard job too.

Unless we do both, we have no idea what the other guys have to deal with.

It's scary as hell to see clots the size of volleyballs out of a uterus. Been there done that. But I'm sure it's also scary as hell to be in the back of an ambulance with a new baby and mom, two potentially unstable patients. Please, let's not attack one another....

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Specializes in Cardiac.
Exactly my point, nurses shouldn't be trash talking about EMS professionals when what we are not doing may not be our fault!! Its not our job to make sure your prepared, if you have concerns take some time and look up the EMS protocols in your state or locality with reference to OB emergencies! Do some of your own research. You honestly think we can go visit every hospital in the area that we cover and advise EVERY L and D RN with regards to what we cannot do? Seriously? You guys do not even respect us when we bring you a healthy, warm baby and a mother who is stable and already has a running IV so when the DOCTOR tells you what to do, you can do it quicker!

Wow..You were the one that asked for help on presenting Precip deliveries.I don't think anyone is expecting any EMS worker to make sure nurses are prepared, but they have no idea what is coming in until it gets there.We all work as a team here.I'm sure in a situation like a precip delivery in the back of an ambulance no one has the time to stop and say "Thank you EMS, for bringing in a healthy baby" we need to make sure that baby that appears "healthy" really is but that doesnt mean your not respected. This is a thankless job! You said you are presenting this to Nurses right? Well you have to make them aware of what can happen and what to expect. That is the point of these presentations, so Nurses can be prepared and provide the best possible care to our patients. And there are many things we nurses can do without the Dr "telling" us to do it. I don't see anyone bashing EMS here, so please stop degrading nurses..your one of us now too.

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Specializes in Labor & Delivery.
You could have easily posted the same information whie leaving your obvious disrespect towards EMS providers out of it!!! For example "EMS brough in a pt and the Paramedic stated proudly, "she's hardly even bleeding!" . Sorry, we do not have doctors to assess our patients and tell us what to do like labor and delivery nurses do.

I've already stated my post was not taken as intended, so i'm not sure what else i can say to apologize. I've worked in facilities where there are no in house docs. We work under standing orders and only call the doc in if needed. So, no docs hanging over our shoulders. We all work hard to acheive good pt outcomes no matter what our role. Hope your class goes well! The most important thing is healthy mom, healthy baby!:)

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Specializes in ER.

I used to do OB, and now I'm in the ER.

I'd be fine with EMT's not massaging the uterus, the placenta may not be out, and the uterus should naturally clamp down. If they load and go, we can deal with it.

I do want to see a warm baby, and skin to skin is the best way to do that. Wrapping the baby right up with mom gives you two patients in one glance. So long as Mom is calm and able to follow instructions she's going to be pretty darn careful.

Do you have pitocin on the trucks?

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Sweetooth: You are getting so defensive. The person posting the message was just answering a question and giving suggestions. I see that you have down that you are a new RN but your passion is ems. Maybe you should stick with ems since you are jumping all over the RN's. No one is putting down other professionals. Don't be so sensitive. EMS is a tough job. EMS is a respected profession and I think everyone would agree with that.

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Specializes in L&D; GI; Fam Med; Home H; Case mgmt.

I know I couldn't do it. It's way too tough for me. I thought about going to EMT school and was actually accepted into the program, then realized I just don't have what it takes. It really does take a special type of person to be an EMT/Paramedic.

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