Adult Post Partum Hemorrhage

Question 1

Adult Post Partum Hemorrhage - Initial actions?

Answer 1

Reassure
Ensure SpO2 > 94%
Place pt supine
Vascular access

Question 2

Adult Post Partum Hemorrhage - Persistent bleeding?

Answer 2

Encourage urination

Perform fundal massage

Question 3

Adult Post Partum Hemorrhage - Persistent bleeding with S/S of shock?

Answer 3

Treat concurrently with shock protocol
If no oxytocin - 10 IU IM
If had oxytocin IM - Oxytocin 40 IU in 1000 ml - start at 150 ml/hr

Question 4

Adult Post Partum Hemorrhage - Bleeding controlled post oxytocin?

Answer 4

Continue infusion and transport

Question 5

Adult Post Partum Hemorrhage - Bleeding uncontrolled post oxytocin?

Answer 5

Mandatory OLMC

Question 6

Adult Post Partum Hemorrhage - Oxytocin indications

Answer 6

Post-partum hemorrhage with S/S of shock

Question 7

Adult Post Partum Hemorrhage - Oxytocin dose

Answer 7

10 IU IM

40 IU in 1000 ml NS infused at 150 ml/hr

Question 8

Adult Post Partum Hemorrhage - Oxytocin EMS precautions

Answer 8

Hypersensitivity
Uterine inversion
Placenta previa
Abruptio placenta

Question 9

Adult Post Partum Hemorrhage - Oxytocin precautions

Answer 9

If bleeding is controlled, continue infusion and transport

If significant bleeding persists, Mandatory OLMC for further direction