Management Of The Pregnant Trauma Patient: Risk Management Pitfalls

Risk Management Pitfalls:

1. Failing to obtain a pregnancy test in any woman of childbearing age. A female trauma patient may be either unaware or unable to communicate that she is pregnant. A positive pregnancy test has important impli­cations for the subsequent management of the patient including avoiding unnecessary radia­tion, monitoring the fetus, and assessment of potential pregnancy complications.

2. Leaving a trauma patient in the later stages of pregnancy in a supine position. After 20 weeks, the gravid uterus can compress the vena cava, which reduces cardiac output and results in hypotension, when the patient is positioned on her back. reducing cardiac output with resulting hypotension.

3. Failing to anticipate a difficult airway when intubating a pregnant trauma patient. Pregnant patients present a potentially difficult airway for several reasons including soft tis­sue edema, decreased pulmonary reserves, and increased aspiration risk.

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