Preeclampsia and eclampsia are uncommon in EMS, but early recognition and treatment can change a patient’s course. In this episode of EMS Clinical Brief, host Dr. Maia Dorsett is joined by Dr. Jenna White, an emergency and EMS physician at the University of New Mexico and chair of ACOG’s Obstetric Emergencies in Non-Obstetric Settings project, and Tim Hutchings, paramedic. Together, they explore blood pressure thresholds that warrant concern during pregnancy and postpartum, symptoms that are easy to miss, and why magnesium is central to treatment. Through clinical cases and candid reflections on changing what we teach, they unpack the evidence behind current guidance and its application in the field—from recognizing preeclampsia with severe features to managing a patient with ongoing seizures.

References/Resources:

1. ACOG Guidelines for Obstetric Emergencies in Non-Obstetric Settings (EMS): https://naemsp.org/news/now-available-new-ems-obstetric-emergency-guidelines/
2. Duley L, Henderson-Smart DJ, Walker GJ, Chou D. Magnesium sulphate versus diazepam for eclampsia. Cochrane Database Syst Rev. 2010 Dec 8;2010(12):CD000127. doi: 10.1002/14651858.CD000127.pub2. PMID: 21154341; PMCID: PMC7045443.
3. Which anticonvulsant for women with eclampsia? Evidence from the Collaborative Eclampsia Trial. Lancet. 1995 Jun 10;345(8963):1455-63.