Saturday, February 7, 2015

Trauma en embarazada

emDocs - February 6, 2014
Authors: Geoff Jara-Almonte, MD (PEM Fellow New York Methodist Hospital) and Hilary Fairbrother, MD (EM Attending NYU)
Editor: Alex Koyfman, MD
"Trauma is the most common cause of non-obstetrical maternal death in the United States, and is estimated to complicate 1 in 12 pregnancies. Blunt trauma is most common, with motor-vehicle accidents, assaults – often a result of intimate partner violence – and falls being the most common mechanisms. Despite this, only a small percentage of trauma patients evaluated at any one institution are pregnant. This novel clinical situation can lead to increased anxiety in an otherwise well-functioning team and may cause providers to become distracted from normal evaluation and treatment algorithms.
It is important to recall that the best fetal resuscitation is good maternal resuscitation. Doing the simple things well, such asoptimizing maternal hemodynamics and oxygenation, will ensure the best fetal outcomes. Preparing ahead of time with simulated resuscitations or mental rehearsal will improve your chance of successfully managing this stressful situation."