Medical Direction Policy

City of Pittsburgh

Emergency Medical Services

3

Title: Transports of Patients in Labor

2.0 An OB kit will accompany the patient from the ambulance until care has been transferred to the appropriate hospital staff.

3.0 In general, EMS personnel will transport patients only to the Emergency Department where the care of the patient will be transferred to a nurse or physician at the receiving hospital. Patients will not be left in the waiting room or at a triage desk without being accepted by a receiving facility nurse or physician.

4.0 EMS personnel may, if requested, transport patients directly to the delivery room if the EMS personnel feel it is in the best interest of the patient or at the request of the emergency department physician.

4.1 Such situations may include patient with an OB emergency, i.e., cord prolapse, third trimester bleeding, fetal distress, eclampsia, altered level of consciousness, etc.

OR

4.2 Signs of imminent delivery including crowning, contraction < 2 minutes apart, patient feeling the need to push or have a bowel movement.

5.0 If EMS personnel transport the patient directly to the delivery room:

5.1 They must be escorted by a hospital nurse or physician.

5.2 Patients will not be transported from the ED without an OB kit. The EMS unit will supply the OB kit if the ED lacks this equipment.

5.3 Transfer to the delivery room must occur immediately. If any delay in this transfer occurs, the EMS crew will transfer the patient to the Emergency Department personnel and onto an Emergency Department stretcher. Report will be given in the usual fashion.

5.4 In several hospitals, the delivery room is some distance from the Emergency Department. In the paramedics judgement, if the patient may deliver prior to arrival in the labor and delivery suite, the paramedics will request that the patient be examined immediately in the Emergency Department by a physician or appropriate nursing staff. Paramedics will standby for transport if necessary.

6.0 Should any problems occur in regard to this policy, you should contact the EMS Supervisor (502) via radio and follow-up the incident with a Quality Management Report Form during the shift.

Approved by: Pittsburgh EMS Medical Direction Committee