Labour and baby-catching in a small ER

[flyingchange]

So the other day we had a young lady present to triage with all-over abd pain, coming in waves, and she was 35 wks pregnant with her first pregnancy. You can see where this is going.Our facility is a very small Emerg. Basically if anything really emergent comes in, we stabilize them and ship out to a bigger hospital. The attending announced that he had delivered his last baby years ago and was arranging for transfer to a major center with a L&D floor.We had the basic equipment for delivery, a warmer, and of course the peds crash cart, but that was about it. No fetal monitor.We hardly ever catch babies. I think, over the facility's history, that there have been 3 or 4 deliveries. Since I just had my L&D rotation, it all kind of came flooding back and I was comfortably timing contractions and coaching the mom to breathe, as well as pseudo-monitoring the FHR with the Doppler (it shows the rate - baseline roughly 140 with decels to 129 after contractions ceased, which worried me). Mom was 9-10 cm dilated and baby's head was engaged, no ROM yet. Contractions were about 1 minute apart for 35 seconds. Mom felt no urge to push or bear down, but if she had I would have convinced her to pant. We got her transferred out soon after.My question to you knowledgeable nurses......what do you do with a laboring patient? Is there anything i should have done differently? Have you got any surprise delivery stories?

[VICEDRN, BSN, RN]

in my two years as an Er RN, I have had multiple precipitous deliveries. last one was 2 months ago.

I have no insight. when they deliver, they deliver. be familiar with the location of the ob kit in your er, set the suction up for munchkin, and remember to keep baby warm after the delivery.