New York State Basic Emergency Medical Technician (EMT-B) Practice Exam

A 25-year-old woman is in active labor with the umbilical cord presenting through the vagina. What should you do?

1. Gently pull on the cord

2. Massage the uterus

3. Replace the cord in the vagina

4. Place the mother supine with hips elevated, administer O2 and transport

The correct answer is: Place the mother supine with hips elevated, administer O2 and transport

In a situation where a woman is in active labor with the umbilical cord presenting through the vagina, the most appropriate action is to place the mother supine with her hips elevated, administer oxygen, and prepare for transport. This approach is critical because a prolapsed cord can lead to cord compression, compromising blood flow and oxygen delivery to the fetus. Elevating the hips helps reduce pressure on the umbilical cord, which may alleviate pressure and delay the effects of cord compression. Administering oxygen to the mother is essential as it can improve oxygenation for both the mother and the fetus. Prompt transport to an appropriate medical facility is necessary to ensure that the mother and baby receive the urgent care they need, as this condition can lead to serious complications if not addressed quickly. In contrast, gently pulling on the cord can increase the risk of tearing it or causing further harm to both the mother and fetus. Massaging the uterus may not address the immediate issue of the prolapsed cord and could exacerbate the situation. Replacing the cord in the vagina is not recommended as it may not alleviate the problem and can still result in fetal compromise. Therefore, positioning the mother for optimal blood flow and getting her to medical care is the best action.