Page 45 - Occupational Health & Safety, February 2018

compressions, consequently decreasing the chance of a successful resuscitation.
■ High-quality chest compressions occur when the woman is supine on a hard surface. If a backboard is used, care should be taken to avoid delays in the initiation of CPR, reduce interruptions in CPR, and prevent line or tube displacement.
■ One-person CPR: Follow the basic life support (BLS) sequence—C-A-B (chest compressions-airway-breathing)—push hard and fast in the center of the chest at a rate of at least 100 compressions per minute with a depth of 2 in (5 cm). Perform this in cycles of 30 compressions and two breaths. The chest compressions are delivered the same way for a pregnant woman as for a non-pregnant woman.
■ Two-person CPR: Use C-A-B-U (chest compressions-airway-breathing- uterine displacement) if two or more res- cuers are at hand. Continuously perform manual left uterine displacement (LUD) when the uterus is felt at or above the um- bilicus (approximately 20 weeks pregnant) to help restore blood flow to the heart by reducing aortocaval compression, the compression of the inferior vena cava and abdominal aorta by the gravid uterus. His- torically, a left lateral tilt of 30° has been used to displace the uterus; however, the heart shifts laterally during this tilt. There- fore, use the left lateral tilt if manual LUD is unsuccessful.
■ If recovered, the pregnant woman should be placed on her left side to increase blood flow to the heart and baby.
AED in Maternal Resuscitation
The best way to save the baby is to save the mother. Rapid defibrillation, when indi- cated, can be life-saving. Use the AED as per standard protocol. The guidelines are the same for the pregnant patient as they are for the non-pregnant patient. Resume compressions immediately after the deliv- ery of the electric shock.
This article is not all-inclusive. Please feel free to contact the author to add infor- mation you think would be helpful in an emergency situation.
Sarah Gherke, MSN, RN, is a staff writer for Pacific Medical Training (https://pacific- medicaltraining.com) of Lower Moreland, Pa. To access Resources for this article, read the online version at www.ohsonline.com.
www.ohsonline.com
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