Question: Although very rare, how should Paramedics manage a uterine inversion?
Uterine inversion is very rare, but can be life-threatening. The majority of uterine inversion will not be apparent from external assessment and thus may be difficult to diagnose in the prehospital setting. As you know paramedics are not authorized to manually replace an inverted uterus. If a midwife is present they will do so by grasping the inverted uterus with a sterile gloved hand by last out, first in technique - pushing the uterus back inside and through the cervix. In the absence of a midwife on scene the paramedic would need to receive medical direction from the on-call base hospital physician.
Careful delivery of the placenta (gentle controlled cord traction during patient pushing/contraction) will dramatically limit the risk of uterine inversion