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Question: Trauma

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A 16 year old female involved in a motor vehicle accident is brought into your trauma bay; she is obviously gravid and states that she is 8 months pregnant.

Which of the following is true of the pregnant trauma patient?

pemsou5_wp • November 23, 2021

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  1. Kelly November 24, 2021 - 1:19 am Reply

    E) If she requires a chest tube, it should be placed 1-2 interspaces higher than usual
    Motor vehicle accidents are the most common type of pregnancy-related trauma and the most common cause of trauma-related fetal death. Improper lapbelt positioning is a major factor – the belt should go under the gravid abdomen across the pelvis, not over the abdomen. Patients should be evaluated in a left lateral position, with a bump under their right side to displace the uterus so it doesn’t compress the IVC. Peritoneal stretching results in decreased sensitivity, so abdominal tenderness may be a less reliable exam finding. Blood pressure is lower during pregnancy but returns to normal in the 3rd trimester; since hypotension greatly raises fetal mortality, low BP should be addressed immediately and not attributed to pregnancy. Preterm labor is a common serious complication in pregnant trauma patients. Other serious, rarer complications include placental abruption, uterine rupture, and amniotic fluid embolus. All Rh negative pregnant trauma patients should receive RhoGham; maternal Rh sensitization can occur with as little as 0.01mL of feto-maternal hemorrhage.

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