SMR and Childbirth

[Inspir]

For the medics:

A question that came up recently was how to perform SMR on a patient with a high index of suspicion for spinal and pelvic injury and have an immediately impending child birth at the scene at a MVC. Which are your priorities? How can you modify SMR in this situation?

 

[Armymedic]

sorry not famil with that acromynm...what is SMR?

 

[Inspir]

It's a new term coming out to replace spinal immobilization. SMR = spinal motion restriction

 

[bisonmedic]

Oh goody, another term change.......can't people leave stuff alone? Anyway, my thought would to be provide basic spinal precautions on the expectant mother and get ready to deliver if required. A C collar is probably the only thing you could use, strapping " Mom" to a board or securing a pelvis is really not going to help when the child is knocking at the door. Depending on your level of care, it's also time to think about pain control options ( MEDS ). We cannot stop the childbirth, but we can try to immobilize the best we can without causing harm to the new baby and mother. It's times like this when you have to get creative, but also remember one thing, call the Dr for advice, I'm sure someone could give advice when something like this happens. I also think that this would be a load and go, I really don't want to stick around with a pt like that, mommy needs a hospital and a surgeon.

 

[Armymedic]

It's a new term coming out to replace spinal immobilization. SMR = spinal motion restriction

:

Well, atleast it is more accurate...

I agree with that bison guy... Drive faster.

It is really situationally dependant. And no matter what you do, the baby is coming.

You could try a short board style immobilization (armpits to top of head) if you got something that will do it. But really, meh?

 

[medicineman]

That sounds like a "What if...?" question from hell.  I'd say scoop, tape, run and pray to the deity/deities of your choice.  If you can use drugs, that would be helpful too.  Barring that, have a big catcher's mitt handy.  OOOPS - almost forgot - if you have no drugs, get hearing protection.

MM

 

[Blackadder1916]

I could say "been there , done that", but the situation (Cold Lake, 30+ years ago) didn't quite rise to the "everything that could go wrong, went" scenario as painted in the opening post.  The expectant mother (G-5 P-4 at the time) had been on her way to the hospital to deliver when the MVA occurred.  As there was suspected c-spine involvement, we used a collar and short board to get her out of the vehicle and onto a long board.   You could say there was a lot of improvising as the equipment we had at the time didn't really fit the need.  But haste was certainly a prime consideration for us (the MAs) as this was our first impending delivery.  The mother was less panicstricken.  As has been noted, there is little you can do to delay the birth so getting the patient to appropriate care is a big factor.  The delivery was completed in the amb at the emerg entrance of CFHCL.  The mother gave us very good instruction in what to do.

 

[Armymedic]

A G-5 P-4 would be a good person to tell you what to expect.