A 28-year-old pregnant woman at 32 weeks gestation is being airlifted after a motor vehicle accident. She has a decreased level of consciousness, hypotension, and abdominal pain. What is the most appropriate first step in managing this patient?
Administer magnesium sulfate for management of premature labor.
Consider performing a perimortem cesarean section in critical situations.
Place the patient in a left lateral tilt position to improve venous return.
Administer corticosteroids to support fetal lung maturity.
The correct initial step is to place the patient in a left lateral tilt position to improve venous return. This action is imperative because the gravid uterus can compress the inferior vena cava when the patient is supine, leading to reduced blood flow to the heart and subsequent hypotension. Addressing this positional issue supports overall circulation, directly impacting the mother and fetus's well-being. While stabilizing airway, breathing, and circulation is also crucial, left lateral positioning is a specific and immediate intervention tailored to pregnant trauma patients to alleviate hypotension and improve hemodynamics.
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