What do I give? How and When?
First line Med for PPH
Given with Hemabate
Immodium
Location of PPH Meds
Omnicell
Would use compression, uterotonics, Bakri and IR for this
Uterine Atony
___ is called when PPH suspected
Provider, resource RN, Charge RN
Second line Med
Methergine or Hemabate
Contraindications for Hemabate
Asthma
Location of Scale
Clean utility
Use repair and packing for this
Laceration/trauma
This person brings PPH cart and scale
runner, resource RN, but NOT primary RN
Contraindications for Methergine
Preeclampsia spectrum and gestational HTN
3rd line drug if Hemabate and Methergine not indicated
Misoprostol
Location of Ultrasound
H22
Would use manual removal and D&C
Retained placenta
This person can do an ongoing QBL
Resource RN NOT primary RN
Medication if Methergine is contraindicated
Hemabate
Route of admin for Miso
Sublingual
Which med is :0.2 mg IM x 1
Methergine
The 4 T's of PPH
Tone, Trauma, Tissue, & Thrombin
Team Check in - name 3/6 discussion topics
VS & LOC, QBL, likely cause, what have we done? What else do we need? Contingency plan
This HTN diagnosis does NOT disqualify Methergine
Chronic HTN with current BP <140/<90
PPH med that is not a uterotonic
TXA
Which med is: 250 mcg IM q 15-90 min
Hemabate
Very rare cause of PPH ...
Coagulopathy
I should suggest moving to the OR if...
bleeding is ongoing and more options are needed, multiple instruments are being used, surgical lighting necessary