NREMT Paramedic Practice

What is the key action to take when a cord presentation occurs?

1. Instruct the mother to push

2. Push the infant back into the vagina and elevate the presenting part

3. Transport the mother immediately without further action

4. Monitor the fetal heart rate and delay transport

The correct answer is: Push the infant back into the vagina and elevate the presenting part

When a cord presentation occurs, the key action is to push the infant back into the vagina and elevate the presenting part. This intervention is crucial because a cord presentation indicates that the umbilical cord is positioned ahead of the presenting part of the fetus, which can lead to cord compression. This compression can restrict blood flow and oxygen delivery to the fetus, leading to fetal distress. By gently pushing the infant back and elevating the presenting part, you create space for the cord, alleviating pressure and improving blood flow. This immediate action can prevent potential complications that could arise from cord compression, such as hypoxia or other adverse effects on fetal health. Transporting the mother immediately without further action may not give the fetus the best chance at a stable condition during transit, and just monitoring the fetal heart rate without intervening could allow for detrimental effects if cord compression is not relieved. Instructing the mother to push is not appropriate since pushing can exacerbate cord compression and lead to worsening fetal distress.