Tuesday, April 16, 2024

MANAGEMENT OF POSTPARTUM HAEMORRHAGE

Table of Contents

REQUIREMENTS #

  • A trolley containing:
    1. PPH pack
    2. Cannular (16/18 guage)
    3. Isotonics IV fluids
    4. Blood volume expanders
    5. Perineal pad
    6. Sterile gallipot
    7. Speculum
    8. Urine catheter
    9. Urine bag
    10. Sterile vaginal
    11. Sterile swabs
    12. Adhesive tape
    13. Vital signs tray
    14. Blood sample bottles
    15. Request form
    16. Foetal Stethoscope
    17. Antiseptic lotion
    18. Oxygen apparatus
    19. Facemask/nasal prong
    20. Suction apparatus
    21. Receiver
    22. Uterotonic drugs
    23. Sponge holding forceps
    24. Blood Pressure apparatus
    25. Thermometer
    26. Pulse oximeter
    27. Sanitary pad
    28. Gynaecological gloves
    29. Antiseptic lotion (Methylated spirit, Savlon, Dettol, Hibitane)
    30. Intravenous. Fluids (Normal Saline, Ringers Lactate)
    31. Intravenous cannula (various sizes)

STEPS #

  1. Establish rapport (refer steps)
  2. Explain procedure to client (refer steps)
  3. Call for immediate help or support
  4. Perform rapid assessment of client’s general condition
  5. Massage uterus to promote contractions and expel clots
  6. Give uterotonic drugs e.g. oxytocin 10 IU IM
  7. Set up IV line and take blood sample for laboratory investigations and arrange for whole blood frozen plasma
  8. Start IV infusion e.g. normal saline and Ringer’s Lactate
  9. Pass indwelling urethral catheter and connect to bag
  10. Monitor intake and output
  11. Assess for signs and symptoms of shock and resuscitate
  12. Assess cause of bleeding
  13. Manage as per WHO/GHS protocols
  14. Counsel mother and family on her condition
  15. Arrange for transfer to higher level if bleeding persists
  16. Prepare client for surgery if indicated
  17. Record all procedures in the Maternal and Child Health Record Book (Manual/Electronic)