EFM NCC; Questions and Answers
Why use fetal monitoring? ✔✔Primary goal is to prevent fetal and maternal
morbidity and
mortality (prevent injury and death to mother and/ or baby), to prevent bad
patient outcomes.
What percent of babies who experience a suboptimal event while being fetal
monitored, develop
cerebral palsy? ✔✔3% of babies with poor tracing develop cerebral palsy
What are most sentinel events due to? ✔✔Poor communication between
providers. Most errors
are traceable back to communication errors.
Sentinel events ✔✔bad things that happen to patients due to a human or
equipment error, and not
due to the reason that they came into the hospital (disease process)
Equipment ✔✔your hands (palpation) use fingertips, ultrasound transducer, FSE,
tocodynamometer, Intrauterine Pressure Catheter, Auscultation (fetoscope,
hand held doppler
, EFM NCC; Questions and Answers
device).
What if you can not get contractions? ✔✔palpate and readjust
IUPC resting tone ✔✔20-25
IUPC resting tone with aminoinfusion ✔✔should not be above 40, troubleshoot
if this is higher,
weigh pads, make sure there is fluid return.
Not meant for meconium or thick mec, they are used for variables or recurrent
variables
✔✔amnioinfusion
Auscultation tools ✔✔intermittent monitoring, use fetoscope or hand help
doppler to trace.
Only true auscultation tool ✔✔fetoscope, the reason is it is the only tool that
listens to the open
and close of the fetal heart valve
Using the doppler or fetoscope ✔✔count the FHR before, during, and after a
contraction.
, EFM NCC; Questions and Answers
Document the baseline rate (range), regular vs irregular, increases or decreases.
Do NOT
document variability, accels, or decels
doppler category 1 ✔✔normal FHR baseline, regular rhythm, presence of
increases from FHR
baseline, no decreases from baseline
doppler category 2 ✔✔includes ANY of the following: irregular rhythm, presence
of FHR
decreases, tachycardia, bradycardia (i feel the need to intervene, I feel like I
can't walk out of the
room)
doppler category 3 ✔✔there is none! auscultation because there is no variabile
determination
with auscultation
goal of external EFM ✔✔external monitoring: goal is to detect fetal heart
movement (efm)
Why use fetal monitoring? ✔✔Primary goal is to prevent fetal and maternal
morbidity and
mortality (prevent injury and death to mother and/ or baby), to prevent bad
patient outcomes.
What percent of babies who experience a suboptimal event while being fetal
monitored, develop
cerebral palsy? ✔✔3% of babies with poor tracing develop cerebral palsy
What are most sentinel events due to? ✔✔Poor communication between
providers. Most errors
are traceable back to communication errors.
Sentinel events ✔✔bad things that happen to patients due to a human or
equipment error, and not
due to the reason that they came into the hospital (disease process)
Equipment ✔✔your hands (palpation) use fingertips, ultrasound transducer, FSE,
tocodynamometer, Intrauterine Pressure Catheter, Auscultation (fetoscope,
hand held doppler
, EFM NCC; Questions and Answers
device).
What if you can not get contractions? ✔✔palpate and readjust
IUPC resting tone ✔✔20-25
IUPC resting tone with aminoinfusion ✔✔should not be above 40, troubleshoot
if this is higher,
weigh pads, make sure there is fluid return.
Not meant for meconium or thick mec, they are used for variables or recurrent
variables
✔✔amnioinfusion
Auscultation tools ✔✔intermittent monitoring, use fetoscope or hand help
doppler to trace.
Only true auscultation tool ✔✔fetoscope, the reason is it is the only tool that
listens to the open
and close of the fetal heart valve
Using the doppler or fetoscope ✔✔count the FHR before, during, and after a
contraction.
, EFM NCC; Questions and Answers
Document the baseline rate (range), regular vs irregular, increases or decreases.
Do NOT
document variability, accels, or decels
doppler category 1 ✔✔normal FHR baseline, regular rhythm, presence of
increases from FHR
baseline, no decreases from baseline
doppler category 2 ✔✔includes ANY of the following: irregular rhythm, presence
of FHR
decreases, tachycardia, bradycardia (i feel the need to intervene, I feel like I
can't walk out of the
room)
doppler category 3 ✔✔there is none! auscultation because there is no variabile
determination
with auscultation
goal of external EFM ✔✔external monitoring: goal is to detect fetal heart
movement (efm)
