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

What should an EMS provider do if the baby's head has been delivered and the amniotic sac is still intact?

1. Puncture the sac and remove the membrane from the baby's mouth and nose

2. Leave the sac intact until after delivery

3. Wrap the sac in a sterile cloth

4. Call for assistance before proceeding

The correct answer is: Puncture the sac and remove the membrane from the baby's mouth and nose

When a baby's head has been delivered and the amniotic sac is still intact, the appropriate action is to puncture the sac and remove the membrane from the baby's mouth and nose. This is essential because the amniotic sac, if not punctured, can prevent the baby from breathing properly as it can cover the mouth and nose. Once the head emerges, it is critical to ensure that there is a clear airway for the newborn, as they need to initiate breathing immediately after birth. The fluid-filled sac may delay this process and could lead to respiratory complications. In addition, while there are considerations for leaving the sac intact until after delivery or calling for assistance, the immediate priority is to ensure the baby's airway is free from obstruction caused by the sac. Hence, the action of puncturing the sac and clearing the airway is vital to support the safe transition of the baby into breathing air outside the womb.