PPH Flashcards
List all possible drugs given in PPH
- Oxytocin 10 IU IM
- Oxytocin 5 IU + 5 IU IV
- Oxytocin 30 IU in 500mls Saline
- Syntometrine 1 ampule + 5 IU Oxytocin IM
- Ergometrine 1 ampule (500mcg)
- Carboprost 250mcg IM
- Misoprostol 800-1000mcg PR
- Tranexamic acid 1g IV
If a woman has cardiac issues and hypertension, which drug is given?
Oxytocin
Contraindications of Syntometrine, Ergometrine, Carboprost
not to be used for…
cardiac and hypertensive patients
liver and kidney disease
Contraindications of TXA
Hx of DVT/ PE
Side effects of Misoprostol
Diarrhoea, pyrexia
What mls/hr is Oxytocin 30 IU in 500ml saline run at?
160 ml/hr
What are the 4 T’s?
Tone
Tissue
Trauma
Thrombin
What bloods are taken?
FBC
Clotting inc Fibrinogen
G + S
X Match
What is the first thing to do to help the placenta to deliver?
Insert a catheter with urometer
How to calculate shock index
Pulse/systolic BP
> 1 suggests decompensation
How should Ergometrine be given?
slow IV injection over 2-3 mins
How long does it take for Oxytocin to act and how long does it last for?
acts in 2.5 mins
lasts for 4 mins
How long does it take for Ergometrine to act and how long does it last for?
acts in 6-7 mins
lasts for 2-4 hrs
At what point does a PPH become an MOH?
Continued bleeding after 1500mls
or
2 units blood transfused
or
vital signs unstable
or
suspicion of DIC
What do you do when an MOH is declared?
Call 4444
ask someone to ‘put out a major obstetric haemorrhage call’
