North Carolina EMT State Practice Exam

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What is the first action to take in cases of a prolapsed cord?

  1. Position mother with knees to chest

  2. Encourage pushing with contractions

  3. Administer oxygen to mother

  4. Start resuscitation of the baby

The correct answer is: Position mother with knees to chest

In the case of a prolapsed umbilical cord, the immediate priority is to alleviate compression on the cord to maintain oxygen and blood flow to the fetus. Positioning the mother with her knees to her chest helps to relieve pressure from the cord and can improve fetal oxygenation. This position maximizes space in the pelvic cavity and can help to reduce the risk of cord compression, which is critical in situations where the cord is at risk of being pinched during contractions or when the fetal head is descending. While other actions might be important later in the management of the situation, such as encouraging pushing or administering oxygen, they do not directly address the immediate issue of cord compression as effectively as positioning does. Starting resuscitation of the baby would only be appropriate after stabilizing the situation regarding the prolapsed cord. Thus, the positioning of the mother becomes the most crucial first step in this emergent scenario.

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