Excellent question.
I would not transport the patient if there was even a remote possibility that she may deliver in flight in a BO-105 due to the space limitations of the aircraft. If the transferring physician is confident she won't deliver in 20 minutes, is he equally confident she won't deliver in 90 minutes? If not, my confidence in the 20 minute guarantee would be greatly reduced.
So no, I would not fly this paient in a BO-105. Either she is stable for ground transport and doesn't meet flight criteria, or she's at risk of delivery in flight in an aircraft that cannot accomodate care for the mother and baby.
>From: Dave Sharpe
>Reply-To: flightmed@flightweb.com
>To: flightmed@flightweb.com
>Subject: High Risk OB dilemna
>Date: Sun, 3 Aug 2003 11:20:15 -0700
>
>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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