Etwell Mari
WA Country Health Service, AustraliaPresentation Title:
The paradigm shift in severe PPH management
Abstract
There is need for a Paradigm shift in massive Post Partum Haemorrhage management approach
from the ALS generic DR ABCDE to the SR. CABCDE or SR. MARCH-OT approach used in
trauma care The SR. MARCH-OT approach is borrowed from the management of exsanguination
haemorrhage in trauma care. This applies well to acute PPH haemorrhage control, hence this
conceptual paper to change the ALSO and PROPMT algorithms in severe PPH management. The
importance of skilled maternity professional and regular drills in managing massive PPH cases is
paramount and cannot be over emphasized. The historical approach borrowed from the ACLS
approach of following the DR. ABCDE algorithm does not address the points of emphasis in
manoeuvres that help quickly control the bleeding, “Closing the tap”. Most obstetric patients are
young and have the physiological reserve to maintain the alertness, Airway and Breathing in the
early stages of bleeding hence emphasis should be on closing the tap and replacing the red cells
and clotting factors while not neglecting the support to Airway and ensuring patient is breathing.
Biography
Etwell Mari is a Fellow of the Australian College of Remote and Retrieval Medicine. He has Dual specialty training in Obstetrics, Gynaecology and Emergency Medicine. Holder of Master’s degree in Critical Care Medicine with special interest in Critical care in resource limited scenarios and critical care outside ICU (Remote retrieval and the prehospital Critical care).
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