Post Partum Haemorrhage (PPH) due to Manual Removal of Placenta immediately after the birth of the patient’s baby so the cause of the bleed was Tissue.
The total measured blood loss was 2000mls/2Litres.
Immediate action was to recognise emergency (pull the emergency bell) and follow our PPH protocol, provide oxygen, another IV access, Fluids, do an immediate haemacue for a rough estitmate of Haemaglobin, Active third stage, 5 minute observations, drugs to control bleeding, Urinary catheter, transfer to Theatre, commence blood transfusions.
Weigh all the blood for accurate measurement of blood loss.
In the essay, to include how a significant bleed affected the patient, talk about how the body compensates she became tachycardic (the heart isn’t getting enough time to refill) her Blood pressure dropped link this to “preload and after load’ in relation to the heart, the clotting cascade the bloods response to the ongoing bleed.
Suggestions for practice:
Have a poster in the delivery room or in the PPH proforma stating how much each swab(large and small), inco sheet and pad weighs for a quicker tally of blood loss as these need to be deducted from the total weight.
During the emergency our protocol states to commence observations (Heart rate, Blood pressure, Saturations) every 5 mins this was done with a mobile blood pressure machine. It would have been easier to do had the labour ward had the blood pressure monitor (Waveform monitor) on the wall like they do in the High dependency area as you can see the trend and record it easily.
Effective use of SBAR (Situation, Background, Assessment, Recommendation) handover during an emergency.
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