Big Belly Baby Bleed – managing late-term Obstetric bleeding

It is ladies month here still – and today we are going to get into one of the the big Emergency scenarios of Women’s health.  Imagine this:

Its a quiet night shift – you are contemplating a third cuppa when the triage nurse rolls in with a young woman on a wheelchair.

Your powers of observation tell you three things:  (1) she is heavily pregnant, (2) she is in a lot of pain and (3) there is a trail of blood flowing behind the wheelchair.

This is not good.  If you work in an adult ED this is probably a pretty rare occurrence – but in a mixed Obs / Paed place this is one of those moments – action stations!

Now I imagine most of you will be thinking – “get that patient outta my ED ASAP!”, however this is a scenario where time is of the essence – and it is worth knowing where the decisions are made, how to start the resuscitation and how do obstetricians think about this scenario

I sat down with my old sparring partner – Dr Wendy Hughes, our resident O&G specialist to go over a case – how should we go about the early management and where are the crucial decision points.

Have a listen and let us know if you have any insights.  There are a heap of pearls and great practical tips crammed into about 20 minutes.

Casey

 

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