Modifications of assessment of trauma patients in presence (or suspect) of pregnancy
- When indicated a thoracostomy tube should be inserted 1 or 2 intercostal spaces upper than usual.
- Vasopressors has to be avoided in pregnancy.
- Perform L.U.D (Lateral Uterus Displacement) to relieve Inferior Vena Cava compression.
- Transport the severely injuried pregnant patient to an hospital with maternal facility if fetus is viable (≥ 23 weeks).
Resuscitation of the pregnant trauma patient
- The utilization of mechanical chest compressors is not recommended.
- Continuous LUD should be performed during resuscitation.
- No modification in energy level when electrical therapy is needed.
- No modification in timing and doses of ACLS drugs.
- Fetal assessment is not indicated during resuscitation.
- Peri Mortem Cesarean Delivery (PMCD) has to be performed without delay and at the site of cardiac arrest (no transport is indicated), after 4 minutes of ineffective resuscitation attempts.