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রবিবার, ২৫ ফেব্রুয়ারী ২০২৪, ১০:৫৪ পূর্বাহ্ন

PPH MANAGEMENT IN A TERTIARY LEVEL HOSPITAL(DMCH)

  • সময় বৃহস্পতিবার, ১ সেপ্টেম্বর, ২০২২
  • ৫২১ বার দেখা হয়েছে
  •  

    (PROFESSOR. NAZMA HAQUE,
    DR.FATEMA-TUZ-ZOHORA,
    DR. K.M. MEHEDI HASAN,
    PROFESSOR. SAYED MUHAMMAD BAQUI BILLAH,
    DR. NAZMUL HAQUE, DR.PRONAY KUMER DEBNATH)

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    1. First of all we should make a team with-
    # Facilitator who will facilitate the team.
    # Team leader who will guide the team.
    # 1st Assistant who will be lead helping hand.
    # 2nd Assistant who will be 2nd helping hand.
    # Recorder who will record all the scenario

    2. We should provide a coiling bell in front of the coridoor.

    Abstract:
    It’s the time 9pm we are in Dhaka Medical College and Hospital at that time An women name Mrs. Anita with bloody wet wear had come. She was Semiconscious, her clothes were mixed with blood. We notice that A canula was inserted on her hand. An ambulance driver had Come to us with a referral paper from where it was written that the patient had given birth a female baby through normal vaginal delivery. The placenta was removed. After that time the per vaginal bleeding was more than average. She was given Oxytocin and misoprostol. But the bleeding was not controlled. And she was referred to Dhaka Medical College Hospital.

    We recorded her vital sign:

    BP-80/50 mmHg
    Pulse- 140b/min
    Temperature- Normal
    P/V/B- More than normal.

    Work for team leader: We treated the patient with first line management (ABCD).

    Work for Facilitator:

    Airway of the patient was open, Brearhlessnees present, tachycardia Present and the patient respond to our command. And by observation The uterus was relaxed, the height of the uterus was high, pervaginal bleeding was more. We gave uterine Massage at that time.

    Assistant-1:
    We used. Inj Tranexamic acid dilute with 10 ml Distil water over 10 min.

    Facilitator:
    Giving uterine massage, Iv fluid, oxytocin, tranexamic acid, has been given but the patient’s condition was not improved.

    Team leader:
    After Checking the vagina and cervix – she didn’t found any tear and a catheter was done.

    Facilitation:
    Though supportive treatment was given per vaginal bleeding was not controlled and patient’s recorded
    pulse-110 b/min.
    Bp-100/60 mm Hg. at that time.

    Team leader: Uterine Balon catheter was done.

    Facilitator:
    Now treat- Bp-80/50 mm Hg
    Pulse- 120b/min
    The patient was going to shock.

    Team leader: NASG (NON-PNEUMATIC ANTI-SHOCK -GARMENT) was done.
    Facilitation: NASG and blood transfusion Refractory PPH was controlled.
    Bp- 100/60 mmHg
    P- 100b/min
    Patient’s response was good.

 

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