迈克尔·莫尔斯（Michael Morse）
They are the best of calls, they are the worst of calls…
Just about every firefighter I know would rather enter a fully involved, occupied fertilizer factory without a charged line than deliver a baby. Until, that is, they deliver one. Field deliveries are a bit unnerving, but they can be one of the most gratifying moments in a firefighter’s career. Sure, your patient load doubles, and it can be a bit messy, but I have found little more satisfying that pressing the mic button with my sweaty fingers, asking dispatch for a time check, and then announcing over the air, “It’s a girl; time of birth 2330 hours.” Even the people listening get a moment of pride and satisfaction and feel a part of something bigger than the job.
Making that announcement is more involved than just saying the words; training and experience certainly help. Having a member of the crew who was present during delivery of a child of his own or who has actually done a field delivery is a luxury and will definitely ease the tension. Understanding our role as health care providers and being proficient is essential.
Chaos is never welcome at any emergency scene, and considering the birth of a child anywhere but in a controlled environment is foolish. Calming the scene and creating a serene atmosphere once you realize that delivery is imminent can be accomplished while attending to the task at hand. The expectant mother and others in attendance need to know that things are as under control as they can be, and it is up to us to be the bringers of calm. By being confident and capable, we do just that.
有些事情要考虑
步骤1：评估是否可以运输到适当的医疗设施。
- 您离该设施有多远？
- 这是第一个孩子吗？有初期儿童的劳动通常较慢。
- 收缩的频率有多？如果不到五分钟，并且每次持续一分钟以上，请考虑到位。相距五分钟以上：强烈考虑运输。
- 水（羊膜囊）破裂了吗？如果是，交货可能即将到来。如果没有，请强烈考虑运输。
- Does the expectant mother feel the need to move her bowels? If yes, there is a good chance the baby’s head is in the birth canal and pressing on the mother’s rectum, creating the sensation of a bowel movement. If no, you may still have time to transport.
第2步：检查母亲。
- 通过专业且知识渊博，您将减轻母亲和其他出席者的大部分关注。说到他人，现在是清除他们的好时机，除了坚持留下的任何人和父亲。您的信心赢得了他们的信任。暴露母亲有点不舒服，但显然是必要的。沟通是关键。解释为什么需要检查。
- 取出可能阻碍考试和分娩的衣服。
- Place sheet, blanket, or whatever is handy beneath the mother’s buttocks and lower back.
- 让母亲弯曲膝盖并张开大腿，以便您可以观察到冠冕（婴儿在出生管中的头部外观）。
Step 3:送货。
- 如果您还没有这样做，请戴上手套。
- 获取您随时可用的任何设备（在每家EMS消防部门的车辆中，都必须使用储存且更新的产妇袋）。
- When the head is visible, support it with one hand. Have a bulb syringe in the other hand.
- Insert the compressed syringe 1 – 1.5 inches into baby’s mouth and slowly release.
- 注意脐带。如果在婴儿的脖子上，请用两个手指将绳索滑到肩膀上。或者，用无菌的手术刀和夹具夹紧，切割和拆开绳索。
- 不要拉；让婴儿来找你。
- Have a sterile (if possible) towel or blanket to wrap the newborn in, pick the infant up to allow mucus to drain from nose and mouth, and assist gently with your bulb syringe. Check for breathing. If yours has resumed, check the newborn. If the infant is not breathing, stimulate by gently rubbing its back or slapping the soles of the feet. If still no response, ventilate with an appropriate device or mouth to mouth, remembering to use tiny puffs. If the infant fails to breathe and the heart rate is below 60, begin CPR with ventilations until transport arrives or the infant begins to breathe on its own.
Do not worry about the cord or placenta. Nature works wonders. The umbilical should become limp and stop pulsating as the baby no longer needs the blood supply. Keep the baby warm, continue suctioning as needed, and prepare to transport two patients!
在正常情况下（值得庆幸的是，大多数活出生都是 - 整个过程都像呼吸一样自然。自从开始以来，母亲就一直在做这件事，通常是无助的。确实会发生并发症，明智的做法是在遇到复杂分娩之前在紧急分娩时进行尽可能多的阅读。始终记住：我们是消防员，护理人员和EMT。我们尽最大努力和培训来尽力而为。有时，我们面临的情况超出了我们的能力和设备。我们所能做的就是最好的稳定和运输。
发动机公司EMS: Using the Tools at Our Disposal
迈克尔·莫尔斯（Michael Morse）is a former captain with the Providence (RI) Fire Department (PFD), an author, and a popular columnist. He served on PFD’s Engine Co. 2., Engine Co. 9, and Ladder Co. 4 for 10 years prior to becoming an EMT-C on Rescue Co 1 and Captain of Rescue Co. 5.
