{"type":"rich","version":"1.0","provider_name":"Transistor","provider_url":"https://transistor.fm","author_name":"The FlightBridgeED Podcast","title":"MDCast: A Tale of Two Patients - Trauma in Pregnancy","html":"","width":"100%","height":180,"duration":2990,"description":"In this episode of FlightBridgeED, Dr. Mike Lauria is joined by maternal-fetal medicine specialists Dr. Alex Pfeiffer and Dr. Liz Gartner for a practical, transport-focused deep dive into trauma in pregnancy. With maternal morbidity and mortality rising in the U.S. and more obstetric patients requiring transfer from smaller facilities, the team breaks down what changes when you’re managing trauma with two patients sharing one circulation—and how pregnancy can mask shock until both mom and fetus suddenly decompensate.They walk through the pregnancy-specific physiology that matters most in the field: increased blood volume and cardiac output, decreased SVR, and why hypotension is a late sign. You’ll hear why “normal blood pressure doesn’t equal normal perfusion,” how to recognize early compensated shock (including subtle mental-status changes and agitation), and the key resuscitation tweaks that make a major difference—especially oxygenation and ventilation targets that are tighter than what you might accept in non-pregnant trauma patients.The conversation also covers the highest-yield operational pieces for EMS and critical care transport crews: aortocaval compression after ~20 weeks and how to relieve it with left tilt/uterine displacement (even on a backboard), what to do about chest trauma (tube placement one to two interspaces higher), why placental abruption is a clinical diagnosis (and often not seen on imaging), fetal heart tones as a “vital sign,” and how viability changes transport destination decisions. They also address Rh considerations, RhoGAM timing, intimate partner violence screening opportunities during transport, and what crews should understand about perimortem C-section even if it’s not in their scope.Key takeawaysMom first = baby best: Maternal stabilization is fetal resuscitation. Prioritize ABCDs before fetus.After 20 weeks: relieve aortocaval compression with 15–30° left tilt, hip bump, or manual uterine displacement—don’t skip this during...","thumbnail_url":"https://img.transistorcdn.com/hprd1ZXbJlsHVwJJj7xopjbDEe3X0jukv-33VpXsuXg/rs:fill:0:0:1/w:400/h:400/q:60/mb:500000/aHR0cHM6Ly9pbWct/dXBsb2FkLXByb2R1/Y3Rpb24udHJhbnNp/c3Rvci5mbS9zaG93/LzQzNDc3LzE2OTAx/MTM1MjYtYXJ0d29y/ay5qcGc.webp","thumbnail_width":300,"thumbnail_height":300}