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welcome PostpartumHemorrhage PPH 岭南医院产科一区曾帅辉 Obstetricdepartment case female 30y at6amtoday gavebirthtoherbaybycesarean thebaby sweightis4700g Amountofbleedingduringoperationwas200ml At7am foundherfundusrisedanduterineconsistencysoft likewaterbag withbrightredvaginalbleedingabout300ml BP 85 51mmHgp 115times minR 24times minWhatisthediagnosis Whyitishappened Whatshouldwedo Objective What Why How definition etiology nursingintervention DefinitionofPPH bloodloss 500mlafterdeliveryPPH occursin24hrsthelatePPH occursafter24hrs 6w ToneTraumaTissueThrombin EtiologyofPPH Nursingintervention 1 Generalnursingmeasures2 Nursingaccordingtothecauses 3 Mentalnursing 1 GeneralnursingmeasuresTogiveoxygen 2L min ToestablishtwovenouschannelTodrawbloodfortypeandcrossmatchTomonitorvitalsignsandurinevolumeContinuetoobservethebleeding Nursingintervention Howtoestimationthebloodloss Visualobservation only50 70 ofbloodlossvolumemethod Weighing Surfacearea bloodstained10cmx10cm 10mlShockindex pulserate systolicpressure Thecauseofthebleeding Thecauseofthebleeding UterineatonyFundusgoesupUterineconsistencysoft likewaterbagAfteruterinemassageorusingoxytocin uterusharden pervaginalbleedinglessen 2 NursingaccordingtothecausesofuterineatonyUterinemassageUterotonicUterinepackingPelvisvesselligationUterinearteryligationHysterectomyArterialembolism new Uterinemassage Singlehandabdominalfundusmassage Handsabdominalfundusmassage Abdominal vaginalHandsuterinemassage Uterotonicagents 1 oxytocin 20uim20u 500NSivdrip 2 carbetocin New 100ug 1miniv 3 Hemabate 250ugim 4 Misoprostol 600ugpervagina Uterinepacking DonnotforgetTakeoutafter24hours Uterinepacking Uterineballoontamponade Pelvisvesselligation Uterinearteryligation Hysterectomy Hysterectomy Arterialembolism New 5 resultisgood 1 stoppingbleedingquickly 6 avoidhysterectomy 4 easyfornursing 2 littletrauma 3 Lesscomplication 3 Mentalnursing Becauseofthebleedingsomepatientsmaybeanxious Weshouldbecalm1 Comfortthepatient2 Encouragethemtoexpresstheirfeelings Encouragethemtoexpressyourfeelings Summary What Why How definition etiology nursingintervention What definition What What Question 1 Whatisthefirstcauseofdeathinpregnantwomeninchina A InfectionB PostpartumHemorrhageC AnemiaD Ruptureofuterus 2 HowmuchbloodlosscanbedefinedasPPH A 500mlB 400mlC 1000mlD 1500ml case female 30y at6amtoday gavebirthtoherbaybycesarean thebaby sweightis4700g Amountofbleedingduringoperationwas200ml At7am foundherfundusrisedanduterineconsistencysoft likewaterbag withbrightredvaginalbleedingabout
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