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YEAR 3 REVISION > Obstetric Emergencies > Flashcards

Obstetric Emergencies Flashcards

1
Q

Which obstetric emergencies should oxygen be given for?

A
  • Anaphylaxis
  • Haemorrhage
  • Eclampsia
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2
Q

What position should the mother be put in for anaphylaxis?

A 
AN = L lateral, tilt head down
PN = flat, elevate legs
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3
Q

Which obstetric emergencies should fluids be given for?

A
  • Anaphylaxis
  • Haemorrhage
  • Eclampsia
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4
Q

What drugs are often given for anaphylaxis?

A
  • Adrenaline
  • Chlorphenamine (antihistamine)
  • Hydrocortisone
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5
Q

How can the airway be assessed to diagnose anaphylaxis?

A
  • Hoarse
  • Stridor
  • Swelling
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6
Q

How can breathing be assessed to diagnose anaphylaxis?

A
  • High RR
  • Wheeze
  • Cyanosis
  • Fatigue
  • Sats <95%
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7
Q

How can circulation be assessed to diagnose anaphylaxis?

A
  • Low BP

- Feeling faint

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8
Q

What skin changes might occur during anaphylaxis?

A
  • Rash
  • Clammy
  • Pale
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9
Q

What are the initial steps in a cardiac arrest?

A
  • 2222 - cardiac arrest
  • Lay bed flat
  • Open airway (chin lift/ jaw thrust)
  • Left uterine displacement
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10
Q

How should CPR be performed on adults?

A

30:2

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11
Q

What drug is often given during a cardiac arrest?

A

Adrenaline

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12
Q

What are the 4 reversible causes of cardiac arrest?

A
  1. Hypovolemia
  2. Hypo/hyper metabolic
  3. Hypoxia
  4. Hypothermia
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13
Q

How can hypovolemia be managed during cardiac arrest?

A
  • Fluids

- Blood transfusion

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14
Q

How can hypo/hyper metabolic be managed during cardiac arrest?

A
  • Calcium gluconate (hyperkalaemia/ magnesaemia/ calcaemia)

- Glucose (hypoglycaemia)

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15
Q

How can hypoxia be managed during cardiac arrest?

A

Effective airway management

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16
Q

How can hypothermia be managed during cardiac arrest?

A
  • Warm IV fluids

- Blankets

17
Q

What are the sepsis 6?

A
  1. High flow oxygen
  2. IV access and bloods
  3. Catheterise
  4. Fluid resuscitation
  5. Blood cultures
  6. Broad-spectrum abx
18
Q

What bloods are taken for sepsis?

A
  • Serum lactate

- FBC, G+S, Us&Es, LFTs, clotting, ABG

19
Q

What are the clinical signs of sepsis?

A
  • RR >24
  • Sys BP <90
  • HR >100
  • Temp >38 or <36
  • Sats <95%
  • Rash
  • Capillary refill <2 secs
20
Q

What other tests should be done for a patient with suspected sepsis?

A
  • Swabs (nose, throat, wound, HVS/LVS, coronavirus)
  • Urinalysis
  • Chest/ abdominal x-ray
21
Q

When should extreme care be taken with fluid resuscitation?

A

Patients with PET

22
Q

When does a serum lactate level indicate possible sepsis?

A

> 4mmol/l

23
Q

What are the first 2 steps of shoulder dystocia management?

A
  • Call for help

- Discourage pushing, lie bed flat, move bottom to edge of bed

24
Q

What are the first 2 maneouvres to try in a shoulder dystocia?

A
  • McRoberts

- Suprapubic pressure (continuous or rocking)

25
Q

If the first 2 maneouvres don’t work, what should be considered next in a shoulder dystocia?

A
  • Consider episiotomy
  • Deliver posterior arm
  • If not possible, internal rotation of shoulders
26
Q

If no maneouvres work, what is the next step for a shoulder dystocia?

A
  • Inform consultant obstetrician and anaesthetist

- Repeat each step + change position if possible

27
Q

What additional management might be considered for shoulder dystocia?

A
  1. Zavanelli’s maneouvre (push head up + CS)
  2. Cleidotomy (separate clavicle)
  3. Symphysiotomy (separate symphysis pubis)
28
Q

What are the 4 possible ways to relieve pressure on the cord during a cord prolapse?

A
  1. Manually elevate PP
  2. Exaggerated sims position
  3. Bladder filling
  4. Tocolysis
29
Q

What is the exaggerated sims position?

A

L lateral with head tilted down

30
Q

What drug is commonly used for tocolysis?

A

Terbutaline

31
Q

What should be done after every obstetric emergency?

A
  1. DDDD

2. Cord gases (if NN emergency)

32
Q

What position should a woman be in if she has a uterine inversion?

A

Lie flat

33
Q

What should be attempted first for uterine inversion?

A

Manual replacement of the uterus

34
Q

What else should be done for a uterine inversion?

A
  • Call for help
  • Oxygen
  • Observations
  • IV access and bloods
  • Fluids
  • Transfer to theatre

YEAR 3 REVISION (49 decks)

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