(3) Start at least two large-bore IV lines. Give crystalloid or colloid as
rapidly as needed to maintain the patient's blood pressure.
(4) To treat for shock, it may be necessary to apply a MAST garment. If so,
inflate the leg sections only of this garment.
2-23. POSTPARTUM HEMORRHAGE
Postpartum hemorrhage is excessive bleeding (hemorrhage) that occurs after
delivery. (Normal bleeding after delivery is one to two cups of blood.)
a. Internal Bleeding. Causes of internal bleeding after delivery include retained
placental products, inadequate uterine contractions, or clotting disorders. Treat as
(1) If the bleeding is profuse, continue uterine massage and put the baby to
the mother's breast.
Continue support of the patient's circulation with colloid or saline by IV.
Transport the patient and baby rapidly to a medical treatment facility.
DO NOT examine the mother's vagina or pack the mother's vagina with
b. External Bleeding. External bleeding may be caused by perineal tears.
Manage such bleeding with pressure. If necessary, open the labia and lay packs at the
2-24. EMERGENCY CHILDBIRTH KEY POINTS
There are five key points to remember in any emergency delivery situation.
a. Most deliveries in emergency childbirth situations progress normally. The
mother is actually the one who delivers the baby. Your job is to assist the mother with
her work and to protect the baby.
b. Evacuate the mother, if possible, unless her labor has progressed to the
c. Once the baby's head delivers, the baby's airway must be open and the baby