Communication with the patient and their family members or close ones has an essential role in patient care. In order to create a feeling of safety, it is important that the patient can speak their native language.
Emergency medical services arrive at a location where a 28-year-old pregnant woman is bleeding profoundly.
Pm: Hello, we are paramedics Lotta and Joel. What is the situation here?
H: My wife is pregnant. She started bleeding heavily half an hour ago.
Pm: How far along in pregnancy is she? How many weeks?
H: She’s at 37 weeks now.
Pm: Has there been any pain during the bleeding?
P: Yes. The pain started when the bleeding began. The pain comes in waves. They feel like contractions.
Pm: Right. I could now palpate your abdomen. Your abdomen is hard and tender to touch. Are you having a contraction now?
P: Yes, I’m having a painful contraction just now.
Pm: Alright. The bleeding is bright red. Did anything special happen before the bleeding started?
H: No, it started spontaneously.
Pm: It may mean that the placenta has detached prematurely.
H: What will happen now?
Pm: We’ll have to rush you to the hospital immediately.
The patient is a 32-year-old woman, on her way to hospital with her husband to give birth. On their way to hospital the woman has an urge to push. The husband calls 112 and they’re waiting for the ambulance in their car by the roadside. When the paramedics arrive, the woman is on all fours on the back seat of the car. It’s their third child.
Pm: Hi! I’m paramedic Lotta and this is my colleague Joel. What is the situation here?
P: Hi. This labour seems to be very quick.
Pm: Oh, right, you did say on the phone that your water has broken. How frequent are the contractions?
P: Yes, my water broke half an hour ago. The contractions are 4–5 minutes apart and they are very painful.
Pm: Alright, how many weeks are you now? Can I see your maternity card?
P: Here you go. I’m 37 weeks.
Pm: Has there been anything special during the pregnancy, for example blood-stained discharge?
P: No, there hasn’t been anything special.
Pm: So you’re a multipara (not a firsttimer). Was there anything special in your previous labours?
P: They have all gone just fine, but my second child was born really fast. We just about reached the hospital. Now I need to push.
Pm: We could now check how the labour is progressing, if you’re ok with that. My colleague could insert a cannula in the back of your hand just in case.
P: It’s fine.
Pm: We can see the baby’s head. (The baby is crowning.) As the contractions are frequent now and you want to push, the baby will apparently be born soon, so we won’t go to the hospital.
P: Alright. May I push now?
Pm: Wait a little. We’ll try to find a good birthing position for you.
P: Thank you. This semi-sitting position is good. The baby is born now!
Pm: You’re doing fine. Remember to breathe. I’ll support the baby’s head so that the baby won’t come out too soon. I’ll help the baby out while you push.
Pm: Congratulations! It’s a girl. Now we’ll drive to the hospital!
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