Postpartum Hemmoage
- Thread starter Canoeman
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austinmedic2004
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Massaging the fundus. We do not give pitocin.
DrankTheKoolaid
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re
fundal massage and pitocin
fundal massage and pitocin
Our protocols:
1) 500ml NS bolus, 2) fundal message 3) Rapid transport. I would check for severe lacerations that could be controlled by direct pressure. Theoretically encouraging breast feeding to release the bodies natural pitocin.
Once to the hospital they will (confirm true PH) most likely try methergine then hemabate.
1) 500ml NS bolus, 2) fundal message 3) Rapid transport. I would check for severe lacerations that could be controlled by direct pressure. Theoretically encouraging breast feeding to release the bodies natural pitocin.
Once to the hospital they will (confirm true PH) most likely try methergine then hemabate.
LucidResq
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O2, fundal massage, have mother nurse pt, establish IV and fluid bolus if hypotensive.
In the OB GYN clinic when we have similar hemorrhage post D&E we give IM methergine and misoprostol rectally, and fundal massage.
In the OB GYN clinic when we have similar hemorrhage post D&E we give IM methergine and misoprostol rectally, and fundal massage.
Fundal massage
High flow O2.
Large bore IV access x2.
D/C LR infusion, initiate NS bolus 20ml/kg. Once available, rapid infusion 2 units PRBC's, type specific if available, O type RH negative otherwise (concurrently infuse 100ml NS to decrease viscocity). Repeat prn based on hemoglobin levels.
FFP - 1 unit per every 5 units of PRBC's infused and 4 units prn for dilutional coagulopathy. Cryoprecipitate for refractory bleeding if available from originating facility.
Platelets - 10 units if available for thrombocytopenia of <50,000.
Pitocin - 5 units IV - OR - Methergine 0.2mg IM
----Followed by----
Hemabate 250mcg IM - OR - Cytotec 1mg PR if refractory bleeding occurs.
Transport to appropriate HROB facility. Notify OB and House Supervisor in flight if possible for surgical services preparation.
High flow O2.
Large bore IV access x2.
D/C LR infusion, initiate NS bolus 20ml/kg. Once available, rapid infusion 2 units PRBC's, type specific if available, O type RH negative otherwise (concurrently infuse 100ml NS to decrease viscocity). Repeat prn based on hemoglobin levels.
FFP - 1 unit per every 5 units of PRBC's infused and 4 units prn for dilutional coagulopathy. Cryoprecipitate for refractory bleeding if available from originating facility.
Platelets - 10 units if available for thrombocytopenia of <50,000.
Pitocin - 5 units IV - OR - Methergine 0.2mg IM
----Followed by----
Hemabate 250mcg IM - OR - Cytotec 1mg PR if refractory bleeding occurs.
Transport to appropriate HROB facility. Notify OB and House Supervisor in flight if possible for surgical services preparation.