Title: Case Study 13-1 Obstetric Emergency
Course: EMS 1119 Emergency Medical Technician > Section: Module XIII Special Patient Populations

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Your BLS unit is dispatched at 10:15 AM to a rural women's health clinic to transport a patient to the hospital 48 miles away for direct obstetrical admission.

Upon arrival you are told your patient is a 37-year-old African American married multigravida. She is 34 weeks pregnant and has come to the women's health clinic for a unscheduled prenatal exam due to symptoms. The clinic nurse has given you report and transfer records. She tells you that this patient has a history of two prior pregnancies resulting in spontaneous abortions at 13 and 14 weeks. The patients third pregnancy resulted in the birth of her 4-year-old daughter at 36 weeks gestation. Today, she came to the clinic complaining of vaginal spotting and cramps. She is a current smoker at one pack of cigarettes every 1 to 2 days. There is a history of hypertension since age 20 and often experiences bladder infections.

You transfer the patient to your stretcher and ambulance.

1. Once the patient is safely secured in the ambulance, what is your first priority?
2. Based on the patients history what is your primary immediate concern with this patient?
3. Your initial vital signs in the ambulance at 10:35 AM were BP 142/92, HR 88 regular, Resp 24, Ox 97% on ambient air. At 10:50 you notice the patient not as alert. What is the cause of this change in status?
4. What is your first treatment priority?
5. A patient with spontaneous abortion or miscarriage present with vaginal bleeding. How is this treated by the EMT?