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产后出血紧急措施POSTPARTUMHAEMORRHAGESTEPSTOAVOIDHYSTERECTOMY
产后出血紧急措施PPH-Oldproblem-newthoughtsPGpotentiatestheactionofoxytocinTamponadetest-TherapeuticDiagnosticUterineCompressionSuturesSevereShockGoldenHour-DefinitiveSurgeryBodyweight–BloodvolumeHb%‘WashOut’phenomenon-fibrinogen/天津塔吊租赁,河北塔吊租赁,西安塔吊租赁,塔吊租赁
产后出血紧急措施PPH-Emergencythatkills
(5’thcommonestcause–CIMD)Anticipate-highriskcases(e.g.twins,polyhydramnios,longlabour,fibroids,APH,infection,pastH/OPPH,retainedtissueetc.)Prevent-Prophylacticoxytocics(e.g.Syntometrine,syntocinon,ergometrine,misoprostol)Manage-promptly-90%uterineatony-8%traumaand2%coagulationdisorders(e.g.Atony-Oxytocininfusion40unitsin500ml-80mu/min-20dropsina20drops/mlgivingset)
产后出血紧急措施
产后出血紧急措施
产后出血紧急措施ProstaglandinpotentiatestheactionofoxytocinStepwisequickprogression-syntometrine/ergometrine/oxytocininfusion/prostaglandinsIV;IM;IntraMyometrialUsemisoprostol400ugrectally/orallywhilstusingoxytocininfusion
产后出血紧急措施LargeboreIVcannulas(gauge14x2)Crystalloids
产后出血紧急措施EmergencyTrolleyEndotrachealtubeLaryngoscopeEssentialdrugsCrystalloids,givingsets,haemacelEmergencyprotocols
产后出血紧急措施PlacentaUterusExternalhandsteadiestheuterinefundusInternalhandalongplaneofcleavageMANUALREMOVALOFPLACENTAAnaesthesiaAntibioticsIVlineOxytocicsCheckplacentaiscompleteChecktheuterusisemptyCheckfortraumaofGT
产后出血紧急措施TAMPONADETESTTherapeuticPrognosticForseverePPHStomachballoonOesophagealballoonCondousG,ArulkumaranSet.al.ObstetricsGynecology.2003
产后出血紧急措施The“TamponadeTest”Therapeutic-Nofurtherintervention(14/16);Continueoxytocininfusionfor12hrs,smallvaginalpack,IVantibiotics,checkfundalheight,bleedingpv.Prognostic-Noneedtodoalaparotomy-answerknowninfewminutes
产后出血紧急措施COMPRESSIONSUTURES
Quick,safeandeffectiveB-LynchHorizontalfullthicknesssutur
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