Bumps and Babes

1. By Christopher I’Anson SJA Advanced Student Doctor Leeds LINKS training Officer 2012-13 Bumps and Babes

2. Topics • Something that is not really covered much... • Obstetrics: • Bleeding • Less movement • Birth/delivery • Unconscious or fitting • Babies: • CPR • Children: • Communication • Reference ranges • Medications • CPR

3. Obstetrics • Obstetrics= babies inside the womb (pregnancy) • From conception-birth • The womb (uterus) increases in size as the baby grows

4. Obstetrics: Questions • If you can remember, ask: • How many weeks pregnant they are • When they are due • Any problems in the past with this or other pregnancies • Everything okay with this pregnancy so far • Number of babies

5. Obsetrics • Movements: • Babies first start to move inside the womb between 16-25 weeks • This is normal • Mums usually know what is normal amount for their baby • Can become decreased normally (sleep) or abnormally • If in doubt send to hospital

6. Obstetrics • There are several things that can occur: • Bleeding These should be dealt • Trauma with as serious and • Less movements needing hospital referral • Vulnerable adult? • Yes pregnant women are; they are more likely to experience domestic violence

7. Obstetrics • Delivery: • Not necessarily an emergency although the mother should get to hospital sooner rather that later • Signs: • Contractions/ pain (1st in 90%) • Waters breaking • Bleeding (be cautious)

8. Obstetrics • What to do? • Do NOTtry to deliver the baby! (unless you are trained at have the correct equipment) • Call for an 999 if delivery is imminent or you are concerned • Treat any other problems like shock • Make them comfortable • No medications! • Can have small sips of water

9. Obstetrics: Eclampsia • This is a serious condition! • It is where a pregnant patient fits due to high blood pressure (after pre-eclampsia) • Actions: • ABCDE • Call 999 and extra help if needed • Try and place patient in the recovery position*

10. Obstetrics: Recover position • Slightly different! • Try to put the patient on to their left side • Does it matter? • Put support under their back

11. Questions?

12. Paediatrics • Babies: • Spotting the sick child • CPR • Choking • Children: • Communication • Reference ranges • Medications • CPR

13. Babies • Not going into much detail about them • Do not see often • Should be seen by an experienced HCP • Hospital and or duty HCP

14. Spotting the sick child or infant • Signs: • Crying • Grunt (in infants) • Cyanosis (blue) • Intercostal recession • Subcostal recession • Tracheal tug • Increased respiratory rate • Nasal flaring http://www.youtube.com/watch?v=U-RfbrnMJZE&feature=related http://www.youtube.com/watch?v=sJLHiTaXrtc

15. Babies • CPR: • Most likely needed due to respiratory arrest • 5 starter breaths • Compressions • Two fingers (same place) • 1/3 of the chest • 30/2 • DEMO

16. Babies • Chocking GROSE!

17. Children • The main difficulty with children is communication • Varies from age to age • Varies from child to child • Varies from situation • Children can be inadvertently misleading • Will respond to closed question (will go with what you say)

18. Children: Presentations • Children can not localise or describe symptoms well • Do not understand • Not experienced enough to localise/ describe • E.g. Tummy pain may mean head pain

19. Children: Top tips • Ask mum/ parent • Get child to be engaged • Play • Be silly (having a few magic tricks will help) • Talk to them • At their level (height and age) • Even if to young to reply

20. Children: reference ranges

21. Children: Doses of paracetamol

22. Children: CPR

23. ANY QUESTIONS?