Gamanit – What are the statistics that you are referring to? It would be nice if I can take a look at those numbers. To say that it is close to nill is very inaccurate, There are algorithms in place for this and these types of emergencies do occur. Not sure from where you take it that there need to be or these patients usually present with a prior indication. While some patients are at higher risk for abruptios and previas one does not need to have any prior indications to have an abruptio or significant post partum hemorrhage. In fact, every woman in the third trimester presenting with abdominal pain is considered to have an abruptio until proven otherwise.
I will ignore the personal attacks, It is irrelevant if I claim to even have any prehospital certification or not. Treating shock is beyond the EMT’s scope of practice. True, the EMTs can place the patient in shock position which might preserve the patients vital organs and even keep the patient warm, yet they cannot offer fluid replacement which is the first step in treating any hemorrhage or even transport to definitive care without an ambulance. Is that not so?
From what I’ve read the risk of hemorrhage post delivery goes up to aproximately 1.5% at about 20 weeks gestation. While you always have to take precautions (if a person complains of chest pains you assume heart attack even though it’s more likely heartburn) the actual risk is fairly low. This 1.5% is risk altogether- if you’ve read enough you know how the typical progression goes. There is pretty much always several hours of worrying symptoms before it becomes actually dangerous. In rare cases it gets serious after only about a half hour or so.
Note – the main reason we are so concerned about abdominal pain in third trimester is because if there is partial placental abruption an emergency c-section can save the baby’s life. I have an online friend who actually had no abdominal pain but called EMS after slipping on the ice and they got her to the hospital on time to do a c-section with no lasting damage. In this case it seems the woman already knew her pregnancy was non-viable. There was no baby to save.
As I’ve said previously- people don’t call third trimester losses a miscarriage. Even laypeople. It sounds like the person who was writing this story was referring to first trimester. While EN doesn’t have their own ambulances, they do transport with other ambulances. They wouldn’t have placed her in shock position and walked off. Typical transport time (even with FDNY these days) would still get her to the hospital with plenty of time to spare.