EMS University

Action

Points Possible

Points Awarded

Takes appropriate PPE precautions

1

Obtains a history relevant to the pregnancy

Estimated date of confinement

1

Frequency of contractions

1

Duration of contractions

1

Intensity of contractions

1

Rupture of amniotic sac (time and presence of meconium)

1

Previous pregnancies and deliveries (complications, vaginal delivery, C-section)

1

Pre-existing medical conditions (HTN, DM, seizure, cardiac)

1

Medications taken prior to labor

1

Pre-natal care (identified abnormalities with pregnancy)

1

Vaginal bleeding

1

Abdominal pain

1

Assessment

Vital signs (BP, P, R, VT, Temperature)

1

Evidence of imminent delivery (crowning, contractions, urge to push, urge to
defecate)

1

Prepares for delivery

Prepares appropriate delivery area

1

Remove patient's clothing

1

Opens and prepares obstetric kit

1

Places clean pad under patient

1

Prepares bulb syringe, cord clamps, towels, and newborn blanket

1

Delivers newborn

During contractions, urges patient to push

1

Delivers and supports the emerging fetal head

1

Checks for nuchal cord

1

Manages nuchal cord if present

1

Suctions mouth and nose with bulb syringe

1

Assesses for the presence of meconium in airway secretions

1

Delivers the shoulders

1

Delivers the remainder of the body

1

Places newborn on mother's abdomen or level with mother's uterus

1

Notes the time of birth

1

Controls bleeding from any traumatic tear of the perineum

1

Reassesses mother vital's sign

1

Newborn care

If meconium is present and newborn is depressed

Performs meconium aspiration

1

Dries newborn (simultaneous stimulation)

1

Continues to suction mouth and nose with bulb syringe

1

Weak or absent cry, poor muscle tone

1

Stimulates newborn

1

Wraps newborn in blanket or towels to prevent hypothermia

1

Clamps and cuts umbilical cord

1

Places on mother's chest to retain warmth

1

Determines 1 minute APGAR score

1

Core cyanosis or persistent acrocyanosis

1

Administers blow-by oxygen

1

Inadequate respiratory rate, tidal volume or persistent core cyanosis

1

Begins positive pressure ventilation with bag-valve-mask and supplemental
oxygen for 30 to 60 seconds and reassesses

1

Heart rate less than 100 bpm

1

Begins positive pressure ventilation with bag-valve-mask and supplemental
oxygen for 30 to 60 seconds and reassesses

1

Heart rate less than 60 bpm

1

Begins chest compressions and positive pressure ventilation with bag-valve-mask and supplemental oxygen for 30 to 60 seconds and reassesses

1

Heart rate remains less than 60 bpm after chest compressions and PPV

1

Considers epinephrine administration

1

Determines 5 minute APGAR score

1

Affective

Accepts evaluation and criticism professionally

1

Shows willingness to learn

1

Interacts with simulated patient and other personnel in professional manner

1