RE: High Risk OB dilemma

["Joe Kubitschek" <joekuby@sbcglobal.net>]

Dave yes, as long as no contractions are occurring and the OB docs agree the
patient is ready.  Better to deliver in a facility that has a Level III NICU
for a 26-week neonate.  Since Mom is a G1P0 chances are this baby is not
going to come ba da boom.  Instead this works for you.  If you have not
worked around Neonates and Mom's yea there is a fear, but in this case I
would feel comfortable.

Also take the NRP and S.T.A.B.L.E. course to give yourself an idea of how to
manage this NICU bab in case you ever do have an oh poop moment!

Joe Kubitschek

-----Original Message-----
From: flightmed-admin@flightweb.com
[mailto:flightmed-admin@flightweb.com]On Behalf Of Dave Sharpe
Sent: Sunday, August 03, 2003 1:20 PM
To: flightmed@flightweb.com
Subject: High Risk OB dilemna


Ok folks, here's a scenario for you.  Your service flies a BO-105
aircraft, and has an agreement with a local OB receiving facility to
provide transport for high-risk OB patients.  On these flights, you
send the aircraft with one Flight Nurse to the receiving facility to
pick up a Labor and Delivery Transport Nurse as part of your team, then
respond to the sending facility 20 minutes away (90 minutes by ground).
  Upon arrival, you find  a 26 week pregnant, G1P0 patient whose cervix
is dilated to 10 cm with intact but bulging membranes.  She came in the
day prior with contractions which were controlled with a MagSo4 drip at
3gm/hr.  She is no longer having contractions.  The sending physician
wants her transferred to the receiving specialty center to manage her
pre-term labor, but does have the capability to resuscitate a preemie
newborn if necessary.
1.)	Would you transport this patient?
2.)	For the sake of discussison, lets stipulate that you're not
comfortable with transporting the patient, but the L&D specialty nurse
and the receiving Perinatologist feel the patient is stable enough to
transport by air, and is not in danger of delivering precipitously
enroute.  Given this information, would you then transport the patient?


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