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Why Are You Bleeding
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100

What are the first non-medication intervention to be done to stop bleeding if uterine atony is the suspected cause?

When atony is suspected, the bladder should be emptied and a bimanual pelvic examination conducted, any intrauterine clots should be removed, and uterine massage should be performed

100

This medication should be reconstitued in either 1000ml or 10ml of NS and has shown it's greatest benefit when used within the first 3 hours of delivery. This is also the timeframe which it should be pushed.

TXA pushed over 10 minutes

100

This is a life threatening condition in which either a portion of or the entire placenta invades into the myometrium and fails to separate from the uterine wall during the third stage of labor

Placenta accreta; in the presence of placenta previa and a history of cesarean delivery, the obstetrician–gynecologist should have a high clinical suspicion for placenta accreta. The risk was far higher in women with placenta previa with 3%, 11%, 40%, 61%, and 67% of such women with their first through fifth or more cesarean deliveries having a placenta accreta. 

100

This amount of bleeding is quite concerning and should trigger preparation for mass transfusion

1500 mL; In women with ongoing bleeding that equates to the blood loss of 1,500 mL or more or in women with abnormal vital signs (tachycardia and hypotension), immediate preparation for transfusion should be made. 

100

Who can/has to activate and deactivate MTP?

The Physican or anesthesia

200

What is the brand name for carboprost, and what is a contraindication for this medication?

Hemabate (Carboprost); Contraindicated in patient with history of asthma

200

This is the name of the intrauterine device that works as a tamponade. This is also the maximum fill for the device. 

Bakri; Max fill 500ml

200

This condition may arise when all clotting factors have been used up

DIC; Disseminated Intravascular Coagulation

200

This QBL is considered a PPH

1000 ml regardless of mode of delivery

200

This is when the PPH Risk Assessment should be done

Admission, prior to delivery, following delivery, change in condition

300

If treatment with medications don't work, treatment with an intrauterine balloon can be considered if there's persistent lower uterine atony. We often use a Jada. How much fluid goes into the cervical seal and to how many mmHg do we set the suction at? Bonus if you can walk through the whole process of Jada insertion

60 mL-120mL; 80 mmHg

300

Do this when the fundus is boggy and deviated to the right


Empty bladder

300

These are the 4 T's that cause bleeding

Tone

Tissue

Trauma 

Thrombin

300

This should be used if the patient does not have a cross match sample in the blood bank

Emergency Release blood (O negative) 

300

Location of the Atony Kit

Refrigerator in Med Room

400

This medication can be given for induction, but also for a PPH. In a PPH it is given rectally. What is the medication and what is the dose range for PPH?

Misoprostol - 600-800mcg

400

What is this suturing technique called ? 

B-lynch; to provide uterine compression 

400

This is the most common cause for PPH

Tone/Uterine Atony

400

This is AMTSL

Active Management of the Third Stage of Labor: Oxytocin administration and gentle cord traction

400

This is how you call for assistance in an OB Emergency

*71

500

What is the route, dosage, and frequency of Methylergovine given in the setting of uterine atony?


Methergine: IM 0.2mg every 2-4 hours


500

Use this when multiple blood products are required.

Level 1 Rapid Transfuser

500

In the event of uterine inversion, manual replacement with or without uterine relaxants usually is successful with the large majority being successfully replaced in one small series. In the unusual circumstance in which it is not, laparotomy is required. These two procedures have been reported to return the uterine corpus to the abdominal cavity. 

The Huntington procedure: Progressive upward traction on the inverted corpus using Babcock or Allis forceps. The Haultain procedure: Involves incising the cervix posteriorly, which allows for digital repositioning of the inverted corpus, with subsequent repair of the incision.

500

What are the components of MTP

PRBC

Platelets

FFP (Fresh Frozen Plasma)

Cryoprecipitate (if ordered by physician)

500

This is a description of the process of obtaining QBL in a vaginal delivery

Calibrated under buttock drape (following placenta - amount present just before placenta), total weight of bloody items minus dry weights

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