EMS Pregnancy Medications || EMS Pharmacology

Dispatch: Medic 21 🚑, you are being dispatched to 123 S Main St. in reference to a 28-year-old female in active labor.🤰🏼Husband states her contractions were 30 seconds apart and she is now feeling the urge to push.

While delivering in the field is not the most ideal, childbirth is a natural process and commonly requires little to no intervention. There are the situations, however, that are very dangerous and/or life-threatening.

Let’s talk about the medications that are used to manage emergencies in our pregnant population.

Magnesium Sulfate - Magnesium sulfate is used for preeclampsia, eclampsia and preterm labor. It induces uterine smooth muscle relaxation and CNS depression. Typically, the preterm labor indication is for interfacility transports only, but scopes & protocols vary greatly from area to area.

Oxytocin - Oxytocin is indicated in the case of postpartum hemorrhage after all traditional methods of bleeding control fail (breastfeeding, fundal massage, etc.). It causes constriction of the spiral arteries decreasing blood flow through the uterus and increasing uterine contractions

TXA - TXA can be used for postpartum hemorrhage. It functions by blocking our body’s own tPA (Tissue Plasminogen Activator) from breaking down desirable clots needed to stop the bleeding.

Diphenhydramine - Diphenhydramine can be used as an antiemetic to treat hyperemesis gravidarum.

Valium - Valium is a benzodiazepine that can be used as an anticonvulsant for eclamptic seizures refractory to magnesium.

Calcium - Calcium chloride/gluconate can be used as an antidote for a magnesium overdose.

Terbutaline Sulfate - Terbutaline is indicated for preterm labor. It works by inducing uterine smooth muscle relaxation.

These nightmare situations are not common in EMS, but they happen. Being knowledgeable about these medications can be key to managing pregnancy emergencies effectively.

🚨 Disclaimer: This is not meant to be used as or in the place of professional medical advice. Always follow your local protocol & scope.🚨

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