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Abdominal bleed in pregnancy
adventuremedic Offline
#1 Posted : 19 May 2012 16:08:22(UTC)
adventuremedic


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I was asked today if you were dealing with a unconscious person who is heavily pregnant how could you detect an internal abdominal bleed??



Never actually considered that the little one would/could be in the way, or indeed that the lower abdomen in a pegnant woman is quite hard anyway.



Answers as ever greatly appreciated, hopefully the whole of todays course are looking for the answer as I have told them how useful this site is.
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JonAcc Offline
#2 Posted : 19 May 2012 22:54:54(UTC)
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Pregnant or not, if MoI carries a risk of internal abdominal bleed, they have one until proved otherwise. It is unlikely that a basic first-aider will gain sufficient experience of palpation to determine whether or not there is a bleed. And if, as indicated, they are unconscious, airway and breathing will be the priorities, the help should have been called pronto, there is nothing a first aider can do to stem internal abdominal bleed.
CARE1 Offline
#3 Posted : 19 May 2012 23:27:25(UTC)
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I agree with JonAcc. If the moi suggests possibility of abdo injury, dont wait for s/s to present - seek immediate medical attention by ambo if necessary. When my wife was "heavily pregnant" she slipped in a car park, fortunately next to a supermarket and just round the corner from a health centre (Not our health centre). Someone advised the supermarket and two of their First Aiders came out at looked after her and they got another member of staff to contact the Health centre. One of the doctors immediately came out and checked her over, including an ultrasound at the health centre tomake sure all was OK. Brilliant!



 
TLC Offline
#4 Posted : 21 May 2012 13:20:51(UTC)
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If you are dealing with any unconscious patient the priority is ABC and urgent removal to hospital.


Recognition of  a internal bleed is  patient is pale, cold, clammy-becoming blue-gray if the bleeding continues. Rapid weak pulse (radial pulse will fade with low blood pressure) rapid shallow bleeding etc etc. Signs of shock


Mechanism of injury plays a large part and any abdominal injury in a pregnant lady needs medical attention, but don’t forget that it might be a spontaneous bleed with no outside trauma.


Detecting a internal bleed is a very hard job and unless it is a severe bleed it unlikely that a first aider  or pre hospital care provider will diagnose this.


I guess if the patient is loosing blood from orifices then that will give a large clue to most first aiders.


I think your students  will be very unlucky if they ever come across that type of injury.  


  


 

kevwilson Offline
#5 Posted : 21 May 2012 13:34:52(UTC)
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If the patient is pregnant and unconscious with internal abdominal injuries, from a first aiders perspective what difference does it make? there is nothing they can do to treat the problem, assuming the 999 call has been made asap, other than to place them in the recovery position injured side down if they are early stage pregnant or left side down in later stage pregnancy to protect the returning blood flow in the vena cava.
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