Category Archives: Featured-TOTW

Management of Uncomplicated Delivery Preparation

TOTW: Management of Uncomplicated Delivery Preparation
Posted on: October 8th, 2021

TOTW: Management of Uncomplicated Delivery Preparation

From the Emergency Child Birth online module:
Preparation for birth (after you have determined it is imminent):
1. Assist patient to a firm, flat surface
2. Patient supine* hips and knees flexed and abducted, perineum visible
3. Provide warmth, ensure adequate lighting
4. Place a plastic bag or sheet, sterile drape under buttocks
5. Wash hands, use sterile gloves

*Suggested optimal positioning. Cannot force mom into this position. If she is too uncomfortable, let her guide what the best position is for her.

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2021 MCME TOTW – Management of Precipitous Delivery

TOTW: Management of Precipitous Delivery
Posted on: September 29th, 2021

TOTW: Determining the Frequency of Contractions

From the Emergency Child Birth online module:

Precipitous Delivery = Birth of a newborn within 3 hours of commencement of regular contractions.

 

Managing a precipitous delivery: Guard the perineum with one hand by putting direct pressure and with the other hand we control delivery of the head so it doesn’t come out as forcefully. Remember to keep the fingers straddled around the fontanels and exert some gentle pressure to avoid a rapid delivery.

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TOTW: Determining the Frequency of Contractions

TOTW: Determining the Frequency of Contractions
Posted on: September 24th, 2021

TOTW: Determining the Frequency of Contractions

From the Emergency Child Birth online module:

Contraction frequency is measured from the START of the first contraction to the START of the following contraction.

Important to know because timing of contractions signals the active/2nd stage of labor, meaning pushing will occur next.

  • Primips (1st delivery) q2-3 minutes
  • Multips (2nd or more delivery) q 5 minutes
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TOTW: 2020 AHA Guidelines Recommends IV Over IO (ACP-Scope)

TOTW: 2020 AHA Guidelines Recommends IV Over IO (ACP-Scope)
Posted on: February 17th, 2021

2020 AHA Guidelines Recommends IV Over IO (ACP-Scope)

New to the 2020 AHA guidelines is the preference for IV medication administration during ACLS, over IO administration.

A recent systematic review found better clinical outcome in patients that received ACLS drug administration via IV vs IO.

 

Consistent with the current ALS-PCS treatment, they state IO access is acceptable if IV access is unavailable.

For more great evidence based recommendations, check out your 2021 MCME Precourse module on the AHA Guidelines Update!

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2020 AHA Guidelines Recommends Resuscitation Debriefing

TOTW: 2020 AHA Guidelines Recommends Resuscitation Debriefing
Posted on: February 17th, 2021

2020 AHA Guidelines Recommends Resuscitation Debriefing

New to the 2020 AHA guidelines is that recommendation for performance-focused debriefing after resuscitation.

Post event debriefing = a discussion between 2 or more individuals in which aspects of performance are analyzed, with the goal of improving care.

There is evidence that shows these debrief sessions (formal and informal) resulted in improved quality of resuscitation (i.e. Increased chest compression fraction, reduced pause) in future resuscitations.

See more great evidence based recommendations in your  2021 MCME Precourse AHA update module!

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Visual on Use of Hydrophobic Submicron Filter

Visual on Use of Hydrophobic Submicron Filter
Posted on: April 15th, 2020
Visual on Use of Hydrophobic Submicron Filter

Here is a video, visually highlighting the use of a hydrophobic submicron filter (HEPA filter) and how it reduces risk of aerosolization as described in our TOTW from March 25, 2020 (here).   In this demo they are using an iGel. But the same principle holds with any airway. Check out 1:25, 2:21 and 3:17 if you don’t want to watch the full 4 min.

You can thank PHCS Mike Filiault for this great find!

https://www.emsworld.com/video/1224178/cy-fair-ems-demonstrates-proper-use-igel-hepa-filter-covid-19-patients

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