Risk Assessment
Low risk assessment.
Singleton Pregnancy
Amount of time indicaded for use of tamponade balloon.
24 hrs.
Contraindications are HTN & Cardiovascular disease
methergine
1st line of help
charge nurse 4355
resident 4146
identify and preparation of placenta previa/accretta, bleeding disorder, declines blood products.
stage 0
Medium Risk Assessment
prior cesarean section
This is used to inflate balloon.
sterile water or sterile saline.
Can be given sublingual/oral/PR. One time only.
Cytotec
APPROPRIATE TO ADD PULSE OXIMETER
<95%
QBL>500 ml or >1,000 ml w/continued bleeding
stage 1
High Risk Assessment
Placenta Previa
Number represents amount balloon can hold.
< or =500 mls
Contraindications is asthma, HTN, active cardiac or pulmonary disease
Hemabate
brings hemorrhage cart, IV starts, weigh blood loos and records/documents all assessments on OB hemorrhage report sheet
Crisis Team
Highly desired if >2 units PRBCs given, or for prolonged PT, PTT.
1 unit=180 ml in volume
Fresh frozen plasma
Medium Risk
Multiple Gestation
This must be removed for trans abdominal placement.
removal of blue cockstop
Best first line product for blood loss
packed red blood cells
Bleeding before birth Position for women in a manner to maximize blood returns from lower extremities.
modified trendelenburg or lateral recumbent position, using SCD's
Priority of risk assessment:
active bleeding on admit: platelets <100,000
low lying lacenta or placenta previa
suspected placenta accreta
hematocrit <30 and risk factors
High Risk
this is QBL for vaginal hemorrhage.
>500
What QBL is needed for debrief.
C/S=1400
vaginal=650
It is used as the last resort when all medications have been used.
Transaxemic Acid (TXA)
Places foley w/urimeter
gets hemorrhage cart
obtains blood products from blood bank or designee
assist with move to OR ( if indicated)
charge nurse ( second nurse)
order massive hemorrhage pack
RBCs + FFP + 1 pack of PLTS