Optimizing systems to manage postpartum hemorrhage

Systems to optimize the management of postpartum hemorrhage must ensure timely diagnosis, rapid hemodynamic and hemostatic resuscitation, and prompt interventions to control the source of bleeding. None of these objectives can be effectively completed by a single clinician, and the management of pos...

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Bibliographic Details
Published in:Best practice & research. Clinical anaesthesiology 2022-12, Vol.36 (3-4), p.349-357
Main Authors: Dulaney, Breyanna M., Elkhateb, Rania, Mhyre, Jill M.
Format: Article
Language:English
Subjects:
delivery of health care/standards
hemorrhage
obstetric hemorrhage
patient care team/organization & administration
patient safety
postpartum hemorrhage
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Summary:Systems to optimize the management of postpartum hemorrhage must ensure timely diagnosis, rapid hemodynamic and hemostatic resuscitation, and prompt interventions to control the source of bleeding. None of these objectives can be effectively completed by a single clinician, and the management of postpartum hemorrhage requires a carefully coordinated interprofessional team. This article reviews systems designed to standardize hemorrhage diagnosis and response. •Uterine atony and coagulopathy can complicate PPH; rapid diagnosis, treatment, and resolution limit the risk of these compounding effects.•A standardized, facility-wide, stage-based obstetric hemorrhage protocol establishes shared expectations amongst the clinical care team.•The decision to transfuse blood should be based on clinical judgment; transfusion protocols get blood products to the bedside.
ISSN:1521-6896
1532-169X
DOI:10.1016/j.bpa.2022.10.001