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ABC and maternal resuscitation

ABC and maternal resuscitation. Aims. Understand primary survey Airway, Breathing, Circulation, Disability Assess and treat in this order To develop and gain competence in the skills needed for maternal Cardio-pulmonary Resuscitation. Airway, Breathing Circulation. Why in this order?

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ABC and maternal resuscitation

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  1. ABC and maternal resuscitation

  2. Aims • Understand primary survey • Airway, Breathing, Circulation, Disability • Assess and treat in this order • To develop and gain competence in the skills needed for maternal Cardio-pulmonary Resuscitation

  3. Airway, Breathing Circulation • Why in this order? • Assess and treat each before progressing onto the next

  4. Ensure safety • Make sure you are not endangering yourself first • Is it safe to approach the patient?

  5. First of all…. • Is the patient just asleep? • Shake and Shout! (remember they might be deaf!)

  6. Call for help • Place patient in tilt, preferably left lateral, 15 to 30 degrees

  7. Assessment • Airway: • LOOK for chest movement • LISTEN for breath sounds, noisy or quiet • FEEL

  8. Airway • Absent or noisy breath sounds? • Open airway • Head tilt and chin lift or jaw thrust

  9. Maintain airway • Measure for and insert Guedel’s airway

  10. Breathing • Is the patient breathing? • What is the respiratory rate? • Too fast or two slow, treat with oxygen

  11. Circulation • Pulse high? • Blood Pressure low? • Skin cold, hot, sweaty? • Conscious level Aggressive, not alert? • Fetal heart fast, slow, absent? • Urine output reduced? • Colour pale, grey?

  12. Circulation • Insert two wide bore lines • Take bloods • Give fluids • Think: Why is there a C problem? • Secondary survey and treat cause

  13. If not breathing....... • Assume cardiac arrest, unless cessation of breathing observed • Commence CPR • 100-120/minute • 30/2 compressions to breaths

  14. Chest compressions • Place heel of hand on lower part of sternum • Place other hand on top and lock fingers • Keep arms straight, lean from shoulders • Depress sternum by 5-6 cms • Rate 120/minute • Very tiring, take turns if possible • 30:2 compressions to breaths

  15. Reassess • Has the cause for the arrest been addressed? • When to stop? • Consider peri-mortem caesarean section • Intended to save mother • Bloodless procedure, do there and then, mother is dead anyway if you don’t

  16. Any questions?

  17. Recap • Assess and treat A then B then C • TILT patient • Always ensure open airway • Give Oxygen if available • Establish IV lines • Secondary survey

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