When seeking emergency preparedness training, CPR certification is one of the most commonly suggested training certifications to receive. While you might be fairly confident in your ability to perform CPR in an emergency situation, would your confidence remain if the victim was pregnant?
A victim of cardiac or respiratory arrest who is pregnant brings a new host of concerns and challenges that must be taken into consideration when administering CPR. From positioning a victim for CPR to considerations for underwire bras and using AEDs, there is a lot to think about in an emergency.
Read on to learn some special considerations for providing CPR to women, as well as guidelines for how bras can affect CPR and the use of AEDs.
Going Beyond The Basics
First off, it’s important to understand the basics of CPR. Our blog on 7 Steps to CPR lays out a fantastic foundation of knowledge for giving CPR.
From there, you can develop and grow in your CPR knowledge. We spoke with one of our outstanding CPR trainers who is a seasoned EMS first responder about the differences between general best CPR practice and the adaptations that should be made for a woman who is pregnant.
Pressures From Pregnancy
If you’ve ever spoken with a woman who is pregnant, there’s no doubt the idea of pressure has come up in various ways. Whether it’s the pressure of swollen feet or increased pressure on their lower back, pregnancy is not always comfortable. But what about internal pressure from their growing uterus?
When conducting CPR in a hospital setting, there are different types of positioning that relieve cardiac pressures. However, most hospitals and clinical settings have a different set of policies and procedures for how to approach and position a pregnant woman in cardiac arrest. There are some basic tips to keep in mind.
In their third trimester, a pregnant woman has likely abandoned sleeping on her back due to the increased pressure and discomfort. This remains true for transporting a pregnant woman on a gurney, trolly, or bed. Transporting the woman on her side removes unneeded pressures and decreases the associated risks.
First Responders & Laypersons
While the basic arrangement of getting a cardiac arrest victim flat on their back is still the ideal starting place, the act of laying a pregnant woman on her back complicates the process of getting blood flowing. In short, with a 10-30 pound uterus laying atop the aorta and inferior vena cava, the additional pressure prevents blood flow.
This position of the uterus interfering with normal blood flow pathways can be remedied with a left uterine displacement. This is where another person can assist the responder providing CPR by grabbing the stomach at the right hip with open palms and fingertips about even with the belly button and pushing gently, but firmly, to the left.
Pictured: Left uterine displacement used to relieve pressure on the aorta and inferior vena cava.
Pregnancy & AEDs
When approaching the use of an AED on a woman who is pregnant, the question of putting the fetus at risk is quick to come up. The concern of shocking a fetus with the electrical impulses meant to save the mother’s life is understandable, however, it has been found to be unwarranted.
According to a statement published by the American Heart Association (AHA), there is no concern for harm to the fetus that outweighs the potential loss of the pregnancy that would occur if the mother did not get life saving care and resuscitation. AEDs should be used to resuscitate the mother, after which she should be placed on her left side to restore blood flow to the fetus.
Underwire Bras, CPR, & AEDs
One question that comes up often when we are asked about giving CPR to a pregnant woman is if there are any special considerations for bras involved in providing CPR and if they would interact with an AED.
Bras & CPR
While a bra does partially cover the area in which CPR is performed, there is no direct impact on how CPR should be conducted. Even the most reinforced, padded, or otherwise stiffened underwire bra would still allow enough access and flexibility to effectively perform chest compressions of two inches.
While a bra would not restrict the ability to give adequate compressions, the likelihood of increased bruising or discomfort in the area is to be expected. Due to the time-sensitive nature of providing CPR, the time spent removing a bra from an unconscious person may prove to be more costly than the person being revived and experiencing chest pains.
In speaking with several EMS professionals who have provided CPR to innumerable patients, we’re not aware of a person who has raised an issue about chest pains that wasn’t outweighed by gratitude for being revived in their greatest time of need.
Underwires & AEDs
Another popular question and often misunderstood myth about AEDs is whether or not the electric shock from an AED could jump to an underwire bra.
We’re not aware of any specific cases of an AED being used and conducting electricity through an underwire bra. This is aided by the fact that most modern AED leads have specially designed sticky dielectric gel with a foam boundary on the edges to help decrease the chances of current going beyond the focused area that the AED is placed.
Despite this not being a concern, the best practice for using an AED still calls for all clothing to be removed from the waist up. This is especially helpful when medical professionals arrive on the scene and can quickly and effectively take over care of the victim without having to delay care by removing clothing.
While there may not be any fundamental changes to how CPR is given to a woman who is pregnant, one key consideration to keep in mind for anyone receiving CPR is modesty and privacy.
In today’s world with everyone having a 4k camera with them at all times, it can be especially tempting to catch the latest emergency on film. The evening news is filled with the latest story of the hero who stepped in and provided care in a moment of need. However, one must be mindful that on the other end of care is someone in an emergency.
When removing or adjusting articles of clothing, using bystanders to help provide some level of coverage or privacy can help prevent an accidental reveal from a bystander who might be live streaming the events in real time. Holding up a jacket or blanket, or even just standing in the way and watching for onlookers can provide much-needed privacy.
Knowing the special considerations and steps to provide CPR to a woman who is pregnant is a great addition to being prepared for an emergency. While the main points of CPR are similar, pregnant women have an extra step that should be taken to provide effective life-saving care.
These tips and guidelines for how to effectively give CPR to a pregnant woman are a great starting place for your training. However, not even the best blog can replace training from highly qualified, experienced staff. Reach out to us at ProTrainings to get CPR certified through our quality curriculum to assure you’ll be ready in an emergency.