Regional Postpartum Hemorrhage Guidelines

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Blood Loss Systolic Blood Pressures Symptoms and signs Degree of shock500-1000 mL (10-15%)Normal Palpitations, tachycardia, dizziness Compensated1000-1500 mL (15-25%)Slight fall (80-100 mm Hg) Weakness, tachycardia, sweating Mild1500-2000 mL(25-35%)Moderate fall (70-80 mmHg)Restlessness, pallor, oliguriaModerate2000-3000 mL (35-50%)Marked fall (50-70 mm Hg) Collapse, air hunger, anuria Severe
• Resuscitation• Oxygen by face mask• IV lines- 2 large bore (16-18 gauge or larger)• Labs• Type and Cross match for 2-6 units (see Massive Blood TransfusionProtocol)• CBC, PT, PTT, Fibrinogen, Fibrins Split Products, Electrolytes andrenal studies• Fluid Resuscitation with NS or LR• Massive Blood Transfusion Protocol• If coagulopathy exists, correct with appropriate replacementproducts• Fibrinogen is preferred because of its volume• Cryoprecipitate
Page 1 and 2: Regional Postpartum HemorrhageGuide
Page 3 and 4: • Shared quality initiatives in O
Page 5 and 6: • Initiated as a result of a cris
Page 7 and 8: • Purpose: To assist medical prov
Page 9 and 10: Risk FactorORRetained placenta3.5Fa
Page 11: • Call for additional help• Nur
Page 15 and 16: • Once activated, the blood bank
Page 17 and 18: • Assess uterus for tone and size
Page 19 and 20: • Uterine Tamponade• SOS Bakri
Page 21 and 22: • Patient should be closely monit
Page 23 and 24: • Document thoroughly throughout
Page 25 and 26: • Fibrinogen > 100mg/dl• Hemato
Page 27 and 28: Specific treatments forPPH
Page 29 and 30: • Early recognition of its cause
Page 31 and 32: • the exclusion of• retained pl
Page 33 and 34: Hydrostatic balloons
Page 35: • Tamponade test Positive (bleedi
Page 38 and 39: • First transcatheter arterial em
Page 40 and 41: • Logistics• Interventional rad
Page 42: • User-friendly suture material m
Page 47: • Multiple full-thickness square
Page 51 and 52: Pelvic pressure pack
Page 53 and 54: • Recombinant factor VIIainduces
Page 55 and 56: • The hemorrhage continues despit
Page 57 and 58: (1) Fresh frozen plasma: 5-10 ml/kg
Page 59 and 60: (1) When no blood is available;(2)
Page 61 and 62: Blood bank
Page 66:
Cell saver
Page 70 and 71:
• Consider availability of resour
Page 72 and 73:
Postpartum HemorrhageClass 1 Class
Page 74 and 75:
To be undertaken simultaneously wit
Page 76 and 77:
• Management:- Secure 2 large bor
Page 78 and 79:
Nursing Station Clerks:• Enter La
Page 80 and 81:
OB Attending MFM Back up OB Residen
Page 82 and 83:
Team CoordinatorAirway managementHe
Page 84 and 85:
• Assist anesthesia as needed•
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Regional Postpartum Hemorrhage Guidelines

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