ALSO Advanced Life Support in Obstetrics mnemonics
0.2 mg IM every 2-4 hours Vocalize no HTN or pre-eclampsia
Methergine (Methylergonovine)
1000 mcg per rectum
Cytotec (Misoprostol, Prostaglandin E1)
0.25 mg IM every 15-90 minutes (max 2mg or 8 doses) Vocalize no pulmonary concerns (Asthma, etc.) AEs: diarrhea, vomitting
Hemabate (Prostaglandin F2 alpha)
Pulse, Pressure, Access (2 large IV), Blood (counts, clotting, crossmatch 4-6 units), Fluids, Drugs
PPH Arms PPABFD
Airway, Breathing, O2, Flat, Recorder
PPH Head ABOFR
Assign Head, Assign Arms, Bladder, Bimanual, 4Ts, continue drugs -> Surgery
PPH Uterus HABB T4 - Surgery
PPH: 10-20 IU IM or 10-40 IU/L IV (500cc over 10 then 250/hr)
Pitocin (Oxytocin)
Evaluate for episiotomy
Shoulder Dystocia E (first E)
Enter rotational maneuvers
Shoulder Dystocia E (second E)
Help, call for it
Shoulder Dystocia H
Legs, put them in McRoberts
Shoulder Dystocia L
Pressure, suprabpubic
Shoulder Dystocia P
Remove posterior arm
Shoulder Dystocia R (first R)
Roll patient to Gaskin position
Shoulder Dystocia R (second R)
Address the Pt, Ask for help, Anesthesia adequate
Vacuum A (3)
Bladder empty
Vacuum B
Cervix dilated completely (and membranes ruptured)
Vacuum C
Determine position of head. Voice Shoulder Dystocia possibility. Review HELPERR
Vacuum D (2)
Equipment check and ready
Vacuum E
Flexion point placement. Feel for maternal tissue
Vacuum F (2)
Gentle traction following pelvic curve, rising as head crowns
Vacuum G
Halt if: 1) 3 pop offs 2) 3 pulls/pushes without progress 3) 20 minutes of use
Vacuum H (3)
Incision: Evaluate for episiotomy
Vacuum I
Jaw: remove cup when jaw is reachable
Vacuum J
