Thursday, July 25, 2024

MANAGEMENT OF ANTEPARTUM HAEMORRHAGE

Table of Contents

REQUIREMENTS #

  1. A trolley containing:
    1. APH pack
    2. Cannular (16/18 guage)
    3. Isotonics IV fluids
    4. Blood volume expanders
    5. Perineal pad
    6. Sterile gallipot
    7. Sterile swabs
    8. Adhesive tape
    9. Vital signs tray
    10. Blood sample bottles
    11. Request form
    12. Foetal Stethoscope
    13. Antiseptic lotion
    14. Oxygen
    15. Facemask/nasal prong
    16. Suction apparatus
    17. Receiver
    18. Uterotonic drugs

STEPS #

  1. Establish rapport (refer steps)
  2. Explain procedure to client (refer steps)
  3. Call for immediate help or support
  4. Assess client’s condition
  5. Take history of description of bleeding (Onset nature and amount)
  6. Set up IV line and take blood sample for laboratory investigations and arrange for whole blood frozen plasma if necessary
  7. Assess clotting status using the bedside clotting test
  8. Start IV infusions e.g. normal saline or Ringer’s Lactate
  9. Check vital signs (Temperature, pulse, respiration and SPO2)
  10. Elevate the foot-end- of bed to aid circulation to the brain
  11. Perform thoroughly examination to assess maternal and foetal wellbeing
  12. Perform gentle abdominal examination noting areas of tenderness, gestational age and presentation and position of foetus
  13. Assess for signs and symptoms of shock and resuscitate
  14. Auscultate fetal heart sound
  15. Identify and diagnose cause of bleeding
  16. Manage in accordance with WHO/GHS protocols
  17. Counsel mother and family on her condition and that of the foetus
  18. Arrange for transfer to higher level if bleeding persists
  19. Prepare client for surgery if indicated
  20. Record all procedures in the Maternal and Child Health Record Book (Manual/Electronic)