Surgery, Trauma, and Transplantation Flashcards
1
Q
postpartum hemorrhage
- stage 1, definition
A
- VSS
- > 500 cc after NVD, OR
- > 1000 cc after C-sec
2
Q
postpartum hemorrhage
- stage 2, definition
A
- VSS
- up to 1500 cc EBL, OR
- ≥ 2 uterotonics given
3
Q
postpartum hemorrhage
- stage 3, definition
A
- VS abnormal, OR
- > 1500 cc EBL, OR
- > 2 units prbc given, OR
- DIC
4
Q
postpartum hemorrhage
- stage 4, definition
A
cardiovascular collapse
5
Q
postpartum hemorrhage
- stage 1, management
A
- iv access
- increase oxytocin
- uterotonic (methergine, misoprostol, carboprost)
- empty bladder
- t&s for 2 units prbc
- fundal massage
6
Q
postpartum hemorrhage
- stage 2, management
A
- additional uterotonic
- bimanual massage
- order 2 units prbc
- cbc, bmp, coags
- give 2 units prbc if above steps ineffective
7
Q
postpartum hemorrhage
- stage 3, management
A
- massive transfusion
- move to OR
- cbc, bmp, coags
- after 2 rounds of MTP consider recombinant factor VIIa
8
Q
postpartum hemorrhage
- stage 4, management
A
- ACLS
- emergent hysterectomy
