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Maternal Collapse Checklist

Action                                                      Time called or performed
Time of arrest/collapse or impending arrest
Press Emergency Call Button


       Dial 8000                              Time called                     Time arrived

•   Arrest team
•   Obstetrician/registrar
•   Paediatrician if >24/40
•   Anaesthetist
(or call specialists by cell phone)


Assign roles/call for further
help                                          Name/time called                 Time arrived
•   Leader (senior MW, O&G or ED

    SMO)
•   Airway + Breathing (A + B)
•   Chest compressions (C)
•   Check List Speaker / Scribe.
•   Communications
•   Logistics (DNM) *9070
•   Midwife/LMC
•   IV access etc
•   Send for 2 units O neg blood
•   Crash Trolley/ Defibrillator
•   Lab: 6 units RBC

         6 units FFP

         1 unit platelets
•   Theatre
•   Peri-mortem C-section pack



                                                  1
Action                                     Name   Time called or
                                                  performed


Lay bed flat/move away from wall
Left lateral tilt if gravid
Open Airway.
Assess responsiveness and breathing
If not breathing start CPR 30:2
Action                                     Name   Time called or
                                                  performed


Attach defibrillator shock if needed
Recommence CPR. Change

person doing compressions.
Large bore IV access x 2 :
Cross match
FBC
LFT & renal function
Coagulation
Adrenaline 1mg IV:
         st
    •   1 dose
         nd
    •   2 dose
Reassess @ 2 minutes
Administer shock if VF/VT
Recommence CPR. Change

person doing compressions
At 4 minutes post arrest commence                 Start:

caesarian.
                                                  Delivered:
Continue CPR, defibrillation,

adrenaline, check for output/rhythm

every 3 minutes during and after

caesarian unless 2 consultants

                                       2
declare patient dead




                              Consider reversible causes of:

          Hypoxia

          Hypovolaemia - haemorrhage or sepsis

          (See APH/PPH algorithm)

          Pulmonary embolism

          Amniotic fluid embolism

          Toxins:

          Magnesium Sulphate - give calcium gluconate (arrest trolley) 1 ampule

          Local anaesthetic - give intralipid (after hours drug cupboard) 50ml

          Tamponade

          Tension pneumothorax

          Hyper/hypothermia

          Hyper/hypoglycaemia




                                                   3

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Maternal collapse checklist

  • 1. Maternal Collapse Checklist Action Time called or performed Time of arrest/collapse or impending arrest Press Emergency Call Button Dial 8000 Time called Time arrived • Arrest team • Obstetrician/registrar • Paediatrician if >24/40 • Anaesthetist (or call specialists by cell phone) Assign roles/call for further help Name/time called Time arrived • Leader (senior MW, O&G or ED SMO) • Airway + Breathing (A + B) • Chest compressions (C) • Check List Speaker / Scribe. • Communications • Logistics (DNM) *9070 • Midwife/LMC • IV access etc • Send for 2 units O neg blood • Crash Trolley/ Defibrillator • Lab: 6 units RBC 6 units FFP 1 unit platelets • Theatre • Peri-mortem C-section pack 1
  • 2. Action Name Time called or performed Lay bed flat/move away from wall Left lateral tilt if gravid Open Airway. Assess responsiveness and breathing If not breathing start CPR 30:2 Action Name Time called or performed Attach defibrillator shock if needed Recommence CPR. Change person doing compressions. Large bore IV access x 2 : Cross match FBC LFT & renal function Coagulation Adrenaline 1mg IV: st • 1 dose nd • 2 dose Reassess @ 2 minutes Administer shock if VF/VT Recommence CPR. Change person doing compressions At 4 minutes post arrest commence Start: caesarian. Delivered: Continue CPR, defibrillation, adrenaline, check for output/rhythm every 3 minutes during and after caesarian unless 2 consultants 2
  • 3. declare patient dead Consider reversible causes of: Hypoxia Hypovolaemia - haemorrhage or sepsis (See APH/PPH algorithm) Pulmonary embolism Amniotic fluid embolism Toxins: Magnesium Sulphate - give calcium gluconate (arrest trolley) 1 ampule Local anaesthetic - give intralipid (after hours drug cupboard) 50ml Tamponade Tension pneumothorax Hyper/hypothermia Hyper/hypoglycaemia 3