Prehospital Trauma Life Support (PHTLS) Practice Test

Why should pregnant trauma patients be placed on the left side?

1. This prevents seizures due to eclampsia

2. This prevents abruption of the placenta

3. This prevents compression of the vena cava

4. This is the best way to auscultate fetal heart tones

The correct answer is: This prevents compression of the vena cava

Placing pregnant trauma patients on the left side is essential primarily to prevent compression of the vena cava, which can occur when a pregnant woman is placed in a supine position. In pregnancy, especially after about 20 weeks, the weight of the uterus can put pressure on the inferior vena cava, a major vein that returns deoxygenated blood from the lower body to the heart. This compression can lead to decreased blood flow and reduced cardiac output, potentially resulting in hypotension and compromised circulation for both the mother and the fetus. When the patient is positioned on her left side, it relieves the pressure off the vena cava, enhancing venous return and improving overall hemodynamics. This positioning is crucial for maintaining adequate blood flow, oxygenation, and perfusion to both the mother and the fetus during traumatic events, thereby supporting better outcomes for both parties. While the other options may present valid concerns in specific contexts surrounding pregnancy and trauma, they do not address the primary physiological reason behind the left lateral positioning during trauma management. For instance, while preventing abruption of the placenta is critical, it is secondary to the immediate need for ensuring adequate venous return.