The team receives advance notification from EMS about a 30 year-old female who is visibly pregnant and was in a car accident. Upon arrival to the ED the patient loses pulses and CPR begins. The team must begin ACLS and proceed to resuscitative hysterotomy. After delivery they should begin neonatal resuscitation and continue management of the mother.  Early consultation should be made to trauma surgery, NICU, and OB.

Goals and Objectives

Educational Goal: To expose learners to a resuscitative hysterotomy (aka perimortem c-section)

Objectives: (Medical and CRM)

Medical Objectives:

1. Demonstrate appropriate ACLS/ATLS involving a pregnant patient.
2. Demonstrate appropriate procedural steps for resuscitative hysterotomy
3. Appropriately manage neonatal resuscitation.
4. Demonstrate ability to manage two critically ill patients at once.

CRM Objectives:

1. Demonstrate ability to lead a code team
2. Communicate effectively with team members.
3. Demonstrate appropriate resource utilization when managing two critically ill patients simultaneously.

EPAs Assessed:

TD 1: Recognizing the unstable/critically ill patient, mobilizing the health care team and supervisor, and initiating basic life support

F1: Initiating and assisting in resuscitation of critically ill patients

C1: Resuscitating and coordinating care for critically ill patients

C2: Resuscitating and coordinating care for critically injured trauma patients

C13: Performing advanced procedures