Episode 9: Maternal Collapse

Mat collapse-2

Apologies for the quality of the sound – we recorded in a very echo-ey office!

The Royal College of Obstetricians and Gynaecologists (RCOG) green top guideline is accessible here:

https://www.rcog.org.uk/globalassets/documents/guidelines/gtg_56.pdf

We have talked about ramping previously, in Episode 6: Oxygenation. This is how a pregnant patient should be positioned for airway manoeuvres and interventions, for example induction of anaesthesia and intubation.

Screen Shot 2016-03-17 at 10.09.34

The ILCOR 2015 update pertaining to Cardiac Arrest Associated with Pregnancy is accessible here:

https://eccguidelines.heart.org/index.php/circulation/cpr-ecc-guidelines-2/part-10-special-circumstances-of-resuscitation/

Including this picture demonstrating manual displacement of the uterus:Manual displacement

The concept of deliberate practice is discussed in more details on these sites:

This is Cliff Reid (resus.me) talking about his lecture from the Royal College of Emergency Medicine Conference in 2015:

http://resus.me/rcem15/

And this is Simon Carley’s (St Emlyn’s) blogpost on the subject:

http://stemlynsblog.org/the-pursuit-of-mastery-through-deliberate-practice/

And last, but not least, Scott Weingart (EMCRIT) from SMACC 2013

http://emcrit.org/podcasts/path-to-insanity/

 

References

Advanced Life Support (7th Edition). Resuscitation Council UK. 2016.

Parry R, Asmussen T, Smith JE. Perimortem caesarean section. EMJ. 2016; 33: 224-229.

Clark SL, Cotton DB, Pivarnik JM et al. Position change and central hemodynamic profile during normal third trimester pregnancy and post partum. Am J Obstetrics & Gynaecology. 1991; 164: 883-887.

Bamber JH, Dresner M. Aortocaval compression in pregnancy: the effect of changing the degree and direction of lateral tilt on maternal cardiac output. Anaesthesia & Analgesia. 2003; 97: 256-258.

Lee SWY, Khaw KS, Kee WN, Leung TY, Critchley LAH. Haemodynamic effects from aortocaval compression at different angles of lateral tilt in non-labouring term pregnant women. British Journal of Anaesthesia. 2012; 109: 950-956.

6 thoughts on “Episode 9: Maternal Collapse

  1. Pingback: Global Intensive Care | LITFL Review 235

  2. Pingback: LITFL Review 235 – FOAM Ed

  3. Hej igen.Der findes en relativ billig målemetode, men den måler kun et øjebliksbillede, så tror ikke det vil kunne fortælle jer særligt meget.Men, ellers er det bare vigtigt at lufte ud så meget som muligt mens der er mennesker i lokalet. Gerne ud af vinduet eller til resten af huset. Evt. skaf nogle planter, de absorberer CO2. Ikke det store, men alt hjælper jo og så er det pænt.Tak for en god blog i øvrigt:-)

    Like

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