During transport, the mother is bleeding through vaginal pad and blood is pooling onto the stretcher. Which action should the paramedic take?

During transport, the mother is bleeding through vaginal pad and blood is pooling onto the stretcher. Which action should the paramedic take?

• A. Administer oxygen and apply another vaginal pad
• B. Administer oxygen and massage the fundus of the uterus
• C. Administer oxygen and place the patient in the Trendelenburg position
• D. Administer oxygen and explain to the patient that bleeding is normal after childbirth

Answer: (B)

Uterine atony is the main reason for heavy postpartum bleeding, so the priority is to promote uterine contraction to compress the blood vessels at the placental site. Massaging the fundus stimulates the uterus to contract, which helps stop the bleeding. Providing oxygen supports perfusion during this hemorrhagic state, but it doesn’t fix the underlying cause by itself. Placing the patient in the Trendelenburg position isn’t helpful for controlling postpartum hemorrhage and can make breathing and circulation harder, especially in late pregnancy or after delivery. Saying that the bleeding is normal after childbirth is unsafe and misleading, as heavy bleeding after delivery requires active management and rapid transport. So, giving oxygen and performing fundal massage to encourage contraction is the best course of action.

Uterine atony is the main reason for heavy postpartum bleeding, so the priority is to promote uterine contraction to compress the blood vessels at the placental site. Massaging the fundus stimulates the uterus to contract, which helps stop the bleeding. Providing oxygen supports perfusion during this hemorrhagic state, but it doesn’t fix the underlying cause by itself. Placing the patient in the Trendelenburg position isn’t helpful for controlling postpartum hemorrhage and can make breathing and circulation harder, especially in late pregnancy or after delivery. Saying that the bleeding is normal after childbirth is unsafe and misleading, as heavy bleeding after delivery requires active management and rapid transport. So, giving oxygen and performing fundal massage to encourage contraction is the best course of action.