PGY 2 PGY 3 SUSTAIN IMPROVE Quickly recognize postpartum hemorrhage call for help and establish safety net PC1 Appropriately evaluates for the 4 Ts tissue trauma tone thrombin ID: 679501
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CRITICAL ACTIONSMSPGY1PGY 2PGY 3SUSTAINIMPROVEQuickly recognize postpartum hemorrhage, call for help, and establish safety netPC1Appropriately evaluates for the 4 T’s: tissue, trauma, tone, thrombinPC1Fundal MassagePC1Appropriate tx including medications doses and contraindicationsMK1Frequent reassessment of vital signsPC1Fluid/blood product administrationMK2Consideration of more aggressive interventionsMK1/2Appropriate studies orderedMK1/2Verbalizes plan for close FUMK 2 PROF2/3TOTALSBP4
SCENARIO ALGORITHMSET UP:Mannequin with fake blood per vaginaMedications: Methergine, Hemabate, PitocinSponges, Foley Bulb, Vaginal Packing MaterialMonitors and equip, IVF, Blood ProdsPRE ARRIVAL:21yo G1P0 s/p forceps delivery 2 hours ago and 2nd degree laceration. Baby 4000g. VS: BP 120/70, HR 90, O2 98%RA, RR 16 Nurse: Bleed whole pad over 15 minutes.Placenta was intactARRIVAL:VS: BP 105/80, HR 105, O2 96%RA, RR 18Heavy Vaginal BleedingUterus boggy2nd tear appears intact w/o bleedPRIMARY SURVEY:A- Airways in intactB- Breathing is non-laboredC- Tachy, vaginal bleedingD- Normal GCSE- Appropriate for situationSECONDARY SURVEY:Not contributory to this situationLABS & IMAGES:H/H: 10/30 after deliveryU/S: No retained productsType and Cross, Coags, Fibrinogen (optional)DISPOSITION:Nursing: continue bleeding checks, fundal checks/massage, vitals Q1H x 3 initially
Simulation Training Assessment Tool (STAT)– Postpartum Hemorrhage
Date:
Instructor(s):
Learner(s):
Learning Objectives:
Recognize postpartum hemorrhage Recognize source from uterus and not due to cervical/vaginal lacerationRecognize appropriate treatment and therapeutic doses of medications
MS = Milestones (see debriefing sheet)