Childbirth/Labor — Adult Algorithm

What position is a laboring patient placed in?

Left lateral recumbent position.

How is the perineum inspected in childbirth/labor?

Visually only.

Is a digital vaginal exam performed in childbirth/labor?

No.

What protocol is used for abnormal vaginal bleeding during labor?

Obstetrical Emergency Protocol, as indicated.

What protocol is used for hypertension during labor?

Obstetrical Emergency Protocol, as indicated.

What protocol is used for hypotension during labor?

Obstetrical Emergency Protocol, as indicated.

What gestational age applies to crowning in the childbirth/labor algorithm?

Greater than 36 weeks.

What access procedure is done for crowning at greater than 36 weeks gestation?

IV Procedure.

What treatment procedure is used for crowning at greater than 36 weeks gestation?

Childbirth Procedure.

What is done if there is no crowning?

Monitor and reassess.

What monitor is applied in the childbirth/labor algorithm?

Cardiac monitor.

What hip position is used for a prolapsed cord?

Hips elevated.

What leg position is used for a prolapsed cord?

Knees to chest.

How is pressure relieved on a prolapsed cord?

Insert fingers into the vagina to relieve pressure on the cord.

What dressing is placed over a prolapsed cord?

Saline-soaked dressing.

When is a prolapsed cord patient transported?

Immediately, unless delivery is imminent.

What is done for the infant airway in prolapsed cord or shoulder dystocia?

Create an air passage for the infant.

How are presenting parts handled in prolapsed cord or shoulder dystocia?

Support the presenting parts.

Should presenting parts be pulled in prolapsed cord or shoulder dystocia?

No.

What transport is used for prolapsed cord or shoulder dystocia?

Immediate transport.

What is done for the infant airway in a breech birth?

Create an air passage for the infant.

What is supported during a breech birth?

The presenting part of the infant.

How many fingers are placed along the infant's nose in a breech birth?

2.

Where are the fingers placed to create an air passage in a breech birth?

Along the side of the infant's nose.

Which direction are the fingers pushed in a breech birth?

Away from the face.

What type of transport is used for a breech birth?

Emergent transport.

What transport positions are used for a breech birth?

Knee-to-chest or left lateral position.

What protocol is used after delivery?

Newly Born Protocol.

What time is noted after delivery?

Time of birth.

What is massaged after delivery?

The fundus.

Why is the fundus massaged after delivery?

To promote uterine contractions.

What bleeding effect does fundal massage have after delivery?

It reduces bleeding.

Should the cord be pulled to hasten placental delivery?

No.