Emergencies

Emergencies

Handling an Emergency Birth 

It’s too late to head to the hospital if she can feel the baby coming and can’t stop pushing, and especially if she can feel the baby’s head. Follow these step-by-step instructions:

If you’re home, don’t attempt to get Mom-to-be into a car and to the hospital. Call 911 and stay on the line. If you’re home alone, try to get someone to assist. If you’re in your car, pull over, put on your flashers and make sure you know the address of where you are or the cross streets.

Something you can wrap the baby in once they're born. Grab two if available. 

Reassure her, tell her everything’s fine. Encourage her to breathe through her contractions to slow the process, instead of pushing. 

Get her to lie back with enough room for you to safely catch your slippery child. First babies usually come slowly but you never know. Be ready.

Wet, slippery and wiggling babies can be tough to catch, so get ready; try to have a safe place for them to land if they slip out of your hands. As the head appears, tell Mom to stop pushing to reduce risks of a tear. 

Let the baby come out on their own; don’t pull. If the umbilical cord is wrapped around your baby’s neck, carefully slide it over their head. Wipe down on their nose to clear mucous, and use a finger to wipe mucous from their mouth.

As the baby is being born, tell Mom to stop pushing and just breathe. If the baby doesn’t slide out, encourage Mom to push a little more. Put one hand under the baby’s head/neck and use the other to grab both feet so the baby doesn’t slip away.

Babies usually start crying within seconds of being born. If the baby isn’t crying, rub their back or chest briskly while wiping them off or slap the soles of their feet. 

Leave it for the paramedics or hospital to handle.

Place the newborn naked on your partner, and then cover them both quickly, making sure you can see their faces. Keep Mom and Baby warm.

EMS Obstetric Delivery Simulation
(No Complications) (3:09)

Wait for the Paramedics

If they aren't available, carefully drive your family to the hospital’s emergency entrance. Do not rush and keep your eyes on the road.

If Your Baby is Choking

Can your baby cry or cough? If not, you must:

1. Give 5 Back Blows

Lay your baby face down over your arm and hit them with the heel of your hand to force out what's in their throat. A solid hit is needed; hit yourself on the chest a few times to determine an appropriate force. Give the baby 5 back blows.

choking

2. Give 5 Chest Thrusts

If #1 doesn’t work, turn them over on your arm and use two fingers to push on their chest to dislodge what's in their throat.

choking

3. Repeat Steps 1 & 2:

Repeat above until effective or until the infant becomes unconscious. If the infant becomes unresponsive, perform CPR. If you see an object in the throat or mouth, carefully remove it without pushing it into the baby’s throat.

choking

© University of Washington. Used with permission.

If Your Infant Needs CPR

If your baby is not breathing, shout and tap her on the shoulder. If there's no response, direct someone to call 911, or dial 911 on your phone, put it on speaker, and do the following:

1. Shout & Tap:

Shout and gently tap the child on the shoulder. If there's no response, and he's not breathing or not breathing normally, position the infant on his or her back and begin CPR.

choking

2. Give 30 Compressions

Give 30 gentle chest compressions at the rate of 100 per minute. Use 2-3 fingers in the center of the chest, just below the nipples. Press down approximately 1½ inches.

mouth to mouth

3. Open the Airway

Open the airway using a head tilt, lifting the chin. Do not tilt the head too far back.

mouth to mouth

4. Give Two Gentle Breaths

If the baby is NOT breathing or not breathing normally, give 2 gentle breaths. Cover the baby’s mouth and nose with your mouth. Each breath should be 1 second long. You should see the baby’s chest rise with each breath. Keep giving compressions and breaths until help arrives.

mouth to mouth

© University of Washington. Used with permission.

First Aid For a Choking Infant (0:41)

Infant CPR (0:36)

When to Call the Doctor & 911

Pediatricians tell you “if in doubt, call.” At first, it can be difficult to know when to call, so err on the safe side. Over time, you’ll learn just by calling. If you’re concerned about splotchy skin, a cough, sneezing, diarrhea, crossed eyes, not eating, etc., check with your nurse hotline or your pediatrician. 

The Mayo Clinic offers guidelines for when to pick up the phone which includes when there are changes in the baby's appetite or behavior, tender navel or penis, high fever, and more.

It also lists information the doctor’s office needs when you do call (baby's symptoms, medical history, feeding and bowel movement changes, etc.)

Immediately call 911 if your child is experiencing any of the following:

  • Difficulty breathing, such as breathing very rapidly.
  • Unconsciousness.
  • Injury in or by a moving vehicle.
  • Serious bleeding or severe burns.
  • Fractured leg or other serious fracture.
  • Seizure.
  • Choking on something you cannot help them expel.
  • Deformity of the skull—a possible skull fracture.
  • Bleeding or clear fluid is streaming from the nose/ear/mouth.
  • A condition you feel is life or limb-threatening.

Call 911 or yell for someone else to do so. Push the speakerphone button on your phone so you can hear instructions while treating your child.

Go to an Emergency Room or Urgent Care facility if your child:

  • Has a serious wound, burn or fractured bone.
  • Needs a head injury evaluated.
  • Needs an X-ray of a possible broken bone.
  • Has a cut that may need stitches.
  • Has a high fever or other serious illness.
  • Has fallen more than 5 feet onto a hard surface.
  • Exhibits any condition you feel may need emergent care.

You can also call your pediatrician or nurse hotline for advice, which may save you a costly emergency room visit.

Babies and their bodies give signals when they aren’t feeling well. The most obvious are fever, runny nose, cough or rash. There are also less obvious signals: the baby may seem lethargic or very cranky, not interested in anything or anyone around them, hasve little or no appetite, be spitting up more than usual, or have stools that are either very hard or runny. The intensity and duration of such symptoms are also factors that will help you, a nurse, or a doctor determine how to treat them.

Poison Control Center

If you suspect your baby has ingested a toxic substance, call the Poison Control Center at (800) 222-1222 before symptoms develop (or even if you just have general questions about poisons). They will ask you what was ingested (check the label) and for an estimate of how much and when it happened. The center will advise you on what to do.

Falls and Bumps on the Head 

Head bonks are common among babies due to the high proportion of their body weight in their heads, and their dumb and fearless nature. Head injuries require extra vigilance, so if Baby tumbles off a couch, trips while toddling around, or falls while trying to climb the bookcase, do a thorough check for injuries and watch them closely afterwards. 

The scalp is rich with blood vessels and even a minor cut can bleed profusely. However, even if the baby appears OK, they may have an internal injury that can be very serious. If your baby does hurt their head, you’ll need to determine how serious it is and how to respond. If it’s obviously serious, call 911.

Take the baby to the doctor or emergency room if:

  • They seem weak or confused.
  • They have trouble moving any body part or there’s an arm/leg deformity.
  • Blood is in the whites of their eyes or pink fluid runs from their nose or ears. 
  • They show signs of concussion: crossed eyes, pupils unequal in size, vomiting.
  • Your baby cries loudly when you move any body part.
  • They are sleeping more than normal.
  • They won’t stop crying.

If no injury is evident but the baby fell from a significant height or was hit with significant force, call the pediatrician or nurse line for advice and direction, as the baby may have suffered a concussion.

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