Comprehensive maternal hemorrhage protocols reduce the use of blood products and improve patient safety

Shields, Laurence E.; Wiesner, Suzanne; Fulton, Janet; Pelletreau, Barbara

doi:10.1016/j.ajog.2014.07.012

Cited by 244 publications

(162 citation statements)

References 31 publications

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“…4,5 Standardized, comprehensive, multidisciplinary programs have demonstrated significant reductions in morbidity. 6,7 Therefore, a workgroup of the Partnership for Maternal Safety, within the Council on Patient Safety in Women's Health Care and representing all major women's health care professional organizations, has developed an obstetric hemorrhage safety bundle. 8 The goal of the partnership is the adoption of the safety bundle by every birthing facility in the United States.…”

mentioning

confidence: 99%

National Partnership for Maternal Safety

Main

Goffman

Scavone

et al. 2015

Anesthesia &Amp; Analgesia

316

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Hemorrhage is the most frequent cause of severe maternal morbidity and preventable maternal mortality and therefore is an ideal topic for the initial national maternity patient safety bundle. These safety bundles outline critical clinical practices that should be implemented in every maternity unit. They are developed by multidisciplinary work groups of the National Partnership for Maternal Safety under the guidance of the Council on Patient Safety in Women's Health Care. The safety bundle is organized into four domains: Readiness, Recognition and Prevention, Response, and Reporting and System Learning. Although the bundle components may be adapted to meet the resources available in individual facilities, standardization within an institution is strongly encouraged. References contain sample resources and "Potential Best Practices" to assist with implementation.

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mentioning

confidence: 99%

National Partnership for Maternal Safety

Main

Goffman

Scavone

et al. 2015

Anesthesia &Amp; Analgesia

316

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“…This includes the use of antifibrinolytics, higher red blood cell-to-fresh frozen plasma ratios, and the increasing use of fibrinogen in MTPs. Shields et al [27] reported that when a maternal hemorrhage protocol was instituted in a 29 delivery units system with more than 32 000 births, the amount of blood products transfused and emergency hysterectomies performed decreased.…”

Section: Protocols and Teamworkmentioning

confidence: 97%

Obstetric hemorrhage

Velde¹,

Varon

2015

Current Opinion in Anaesthesiology

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Postpartum hemorrhage is best managed by using a stepwise progressive approach. Manual and pharmacologic interventions are first-line treatments. Second-line treatments are used when bleeding continues; and hysterectomy is reserved for only the most extreme cases. Outcomes may be improved by thorough preparation, anticipating the risk of obstetric hemorrhage, and coordinating consultants for interventional procedures.

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“…Algorithms reflected in posters must be located at critical points of obstetric spaces for easy reference. Some publications [63,64] show that the new application of a PPH protocol was associated with the resolution of maternal bleeding at an earlier stage or the use of fewer blood products.…”

Section: Use Of Protocolsmentioning

confidence: 99%

Massive Postpartum Hemorrhage: Protocol and Red Code

Masip¹,

Almeida-Toledano²,

Ferrero-Martínez³

et al. 2017

Obstetrics

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Postpartum hemorrhage (PPH) is the leading cause of maternal death. In developing countries, approximately 8% of maternal death is caused by PPH. Protocols should provide a standardized approach to evaluate and monitor the patients. A standard protocol must be recognized by the institution and must be accepted and known by all team members. Additionally, it is important to have a massive obstetric hemorrhage protocol (red code) for those patients with an important bleeding who require blood products available as soon as possible. In the red code activation protocol there are several key points to consider: the management algorithm must be known and accepted by all team members, a clear and effective communication between the team must be established and all the participants must know the role they play. Massive obstetric hemorrhage has a multidisciplinary implication: obstetricians, anesthesiologists, pediatricians, midwife, nurses, auxiliary staff, and laboratory blood bank staff. The active participation of the multidisciplinary team in simulations before the protocols implementation facilitates the evaluation of critical points and subsequent changes before their final application, the assessment of the adequacy of circuits and infrastructure, as well as a better protocols compliance.

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Comprehensive maternal hemorrhage protocols reduce the use of blood products and improve patient safety

Cited by 244 publications

References 31 publications

National Partnership for Maternal Safety

National Partnership for Maternal Safety

Obstetric hemorrhage

Massive Postpartum Hemorrhage: Protocol and Red Code

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