Reference Number OB/G-1

OBSTETRIC/GYNECOLOGY

REFERENCE NO. OB/G-1

SUBJECT: CHILDBIRTH

PROCEDURAL PROTOCOL:

This protocol applies to a woman in active labor. Obtain mothers history and physical.

HISTORY	PHYSICAL
Months pregnant	Vital signs
Date of last period	Skin signs
Contractions: Duration, interval	Cord visible or presenting parts in vagina other than head
Vaginal bleeding, present, amount?	Head crowning
Previous deliveries	Urge to push
APGAR Score for baby (if Birth has occurred)	Active vaginal bleeding
Known abnormal presentation or obstetrical complication	Ruptured membranes
Single or multiple gestation	Meconium staining

DELIVERY NOT IMMINENT:

Transport mother in left lateral recumbent position.

DELIVERY IS IMMENENT:

See Childbirth Algorithm page 2.

APGAR SCORING CHART

	SIGN	0	1	2
A	APPEARANCE (Color)	Blue, pale	Body pink, hands and feet blue	Completely pink
P	Pulse (Heart Rate)	Absent	Slow (below 100)	Over 100
G	Grimace (Muscle Tone)	Flaccid limp extremities	Some flexing of extremities	Active motion
A	Activity (Response to flick on sole)	No Response	Some motion, cry	Couth, sneeze, vigorous cry
R	Respiratory effort	Absent	Slow, irregular	Good, crying

EFFECTIVE DATE: 1-1-03
REVISED: 2-02
APPROVED: 2-02
NEXT REVIEW DATE: 2-06

SUPERSEDES: REFERENCE
NO. I-A-18

APPROVED:	William Koenig, M.D. S-SV EMS Medical Director
	Leonard R. Inch S-SV EMS Regional Executive Director