The Use of Technology to Support Obstetrical Emergency Preparedness

Welcome – You find yourself in the scenario listed below.

The phone call comes in. A patient who has delivered at home without health care provider in attendance is coming in via EMS with a postpartum hemorrhage. It is her fourth baby and she tells the paramedics that “last time she had some bleeding, I think they maybe had to give me some kind of infusion.” The charge nurse takes the call, the attending Obstetrician is aware, anesthesia on call is aware and you have been assigned to be patient care nurse upon arrival. Your stomach flips, you are running over all the possible scenarios of a postpartum hemorrhage in your head.

But what to do first? And then it hits you – the eSimulation you did last month as part of your annual recertification.

Your nerves begin to settle slightly and you work your way through the steps you learned in the eSim.

Step 1: Assess vitals

Step 2: Perform fundal massage to assess peri-vaginal bleeding

Step 3: Administer oxytocin through peripheral intravenous started by paramedics

Step 4: Consider administering intravenous fluid bolus

Step 5: Consider having anesthesia come for support

....And the steps continue, running through the rest.

The moment the patient arrives you are ready to act, thanks to obstetric-specific training. Ready to facilitate high provision of evidence-based care and interventions solidified by hands on obstetrical simulations.

You acted with other members of your team. You took the necessary steps. The patient will be okay. Well done.

Disaskos et al., (2010) supports this type of learning in this way by listing these key points within their article:

• “Obstetric-specific team training interventions have provided clinical improvements.”

• “Training within the institution allows departments to identify and solve local safety problems using tailored management protocols and guidelines adapted for specific emergencies.”

• “Realistic training tools, especially training in obstetric emergencies using simulation, will lead to improved confidence, knowledge, and clinical management compared with teaching only by didactic lectures.”

Reference

Diasakos, D., Crofts, J.F., Winter, C., Weiner, C.P. & Dracut, T.J..(2010). The Active Components of Effective Training in Obstetric Emergencies. Obstetric Anesthesia Digest, 30, 145-146. https://doi.org/10.1097/01.aoa.0000386815.92439.5c

Image taken from https://www.everydayhealth.com/fertility/uterus-removal-for-postpartum-bleeding-is-too-common/