POST PARTUM HEMORRHAGE

OB ADVERSEEVENTSPOST PARTUMHEMORRHAGE

POSTPARTUMHEMORRHAGE• “Preventing Maternal Death” by Steven L.Clark, MD, and Gary D.V. Hankins MD– Angiographic Embolization is not meant to beused for Acute, Massive Postpartum Hemorrhage– If more than a single dose of medication isnecessary to treat uterine atony, go to thepatient’s bedside until the atony has resolved.

POSTPARTUMHEMORRHAGE• “Preventing Maternal Death” by Steven L.Clark, MD, and Gary D.V. Hankins MD– Never Treat “Postpartum Hemorrhage” withoutsimultaneously pursuing an actual clinicaldiagnosis– In the postpartum patient who is bleeding or whorecently has stopped bleeding and is Oliguric,Furosamide is NOT the answer

POSTPARTUMHEMORRHAGE• “Preventing Maternal Death” by Steven L.Clark, MD, and Gary D.V. Hankins MD– Any woman with Placental Previa and one or morecesarean deliveries should be evaluated anddelivered in a Tertiary Care Medical Center– If your Labor and Delivery Unit does not have arecently updated Massive Transfusion Protocolbased on established Trauma Protocols, get oneTODAY

POSTPARTUMHEMORRHAGE• DISCOVERY– Standard of Care for Postpartum Hemorrhage– Massive Transfusion Protocol– No risk assessment– No procedural checklist

POSTPARTUMHEMORRHAGE• Creating the Team– OB’s– Anesthesia– Critical Care– Lab– Nurse Leaders– Clinical Educators

POSTPARTUMHEMORRHAGE• Revised Massive Transfusion Protocol• Updated PP Hemorrhage Standard of Care toinclude Massive Transfusion Protocol• Developed PP Hemorrhage checklist – Nursing• Developed PP Hemorrhage checklist –Anesthesia

POSTPARTUMHEMORRHAGE• SPREADING THE WORD– Nursing Grand Rounds – update Code OB - Drills– OB Department Meetings– Anesthesia Department Meetings– Unit Meetings– Self Learning Packets– PP Hemorrhage Packets