management of haemorrhage ppt

Values: The evidence was reviewed by the Women’s Following an antenatal admission for APH, the O&G will record a management plan in the woman’s records on MCIS for on-going care. APH is associated with increased foetal and maternal morbidity and mortality. Active man- agement of the third stage of labor should be … However, this often led to a lethal triad of acidosis, hypothermia, and coagulopathy. The PowerPoint PPT presentation: "Surgical Management of Post Partum Haemorrhage" is the property of its rightful owner. It was a cross sectional study conducted at Liaquat National Hospital Karachi, during the … The terms intracerebral hemorrhage and hemorrhagic stroke are used interchangeably in this article and are regarded as separate entities from hemorrhagic transformation of ischemic stroke. AND ITS MANAGEMENT PRESENTED BY: DR. MUKESH KUMAR M.D.S. NINDS U01 NS106513. Our objective was to evaluate the most common etiology and method of management of Post partum Hemorrhage in a tertiary care hospital of Karachi. Bleeding can be a complication of laparoscopic procedures commonly performed by urologists, such as pelvic node dissection and nephrectomy, and is often difficult to manage. Background Post partum hemorrhage is defined as blood loss of 500 ml or above. Management of delayed suprachoroidal haemorrhage after intraocular surgery and trauma. 2032 Purpose—The aim of this guideline is to present current and comprehensive recommendations for the diagnosis and treatment of spontaneous intracerebral hemorrhage. Hemorrhage is an acute loss of blood from a damaged blood vessel. 5,12-15 While more research is needed, active management reduces the risk of additional uterotonic drug therapy, severe maternal hemorrhage >1,000 mL, maternal blood transfusions, postpartum maternal hemoglobin <9 g/dL, and mean maternal blood loss at birth. Introduction. Important initial steps. Subarachnoid haemorrhage accounts for only 5% of strokes, but occurs at a fairly young age. The most common causes of maternal death are pregnancy induced hypertension (PIH), embolism, and obstetrical hemorrhage. Specific antidotes for these drugs are expected to be available soon. RELATED TO ACTIVE BLEEDING THAT MAY PROCEED FOR HOURS AFTER SYMPTOM ONSET TENDS TO OCCUR EARLY INCREASES RISK OF POOR FUNCTIONAL OUTCOME AND DEATH 28%-38% HAVE HEMATOMA EXPANSION OF GREATER THAN 1/3 OF THE INITIAL HEMATOMA VOLUME ON FOLLOW UP CT Hemphill, J.C., et al (2015). Management of delayed cerebral ischemia after subarachnoid hemorrhage. All expectant women are considered to be at risk of PPH and its effects. Major Obstetric haemorrhage (MOH) remains one of the leading causes of maternal mortality & morbidity worldwide. Poster: Massive Transfusion Protocol (Blood Bank) Poster: Surgical Management. Guideline management principles and goals The principles of this guideline are: Reduce risk of PPH It can also be significant, leading to a more ambiguous constellation of symptoms, including fluctuations in vital signs and altered mental status. Risk of rebleeding after treatment of acute hydrocephalus in patients with aneurysmal subarachnoid hemorrhage. Active management of 3rd stage as PostPartum Haemorrhage (PPH) should be anticipated in all women who have experienced APH. Although the diagnosis of vitreous hemorrhage is generally straightforward, management is dictated by uncovering the underlying etiology. Risk of rebleeding after treatment of acute hydrocephalus in patients with aneurysmal subarachnoid hemorrhage. About 14 results (1.23 milliseconds) ... Nutritional Management Of Traumatic Brain Injury PPT. anticoagulants, bleeding is the major complication of therapy. Avg rating:3.0/5.0. Postpartum Haemorrhage (PPH) By Bernadette Gregory, Senior Lecturer in Midwifery Updated by Jacqui Williams, Senior Lecturer in Midwifery Definitions An excessive ... – PowerPoint PPT presentation. Bleeding, also called hemorrhage, is the name used to describe blood loss. Hellingman CA, van den Bergh WM, Beijer IS, et al. This is due to a combination of the development and implementation of new techniques and pharmaceuticals, in addition to a vast volume of data from randomised trials dealing with management issues in this condition. Obstetric Hemorrhage - Paul Ogburn, MD - PowerPoint Presentation Author: Paul Ogburn, MD, Director, Maternal-Fetal Medicine, Stony Brook University Subject: Obstetric Hemorrhage - The information posted provides information about how to prevent and best manage maternal hemorrhage, which will reduce the risk of maternal death. 21. rupture, retained placental tissue, and maternal bleeding disorders [1]. At 24 hour postpartum – moist heat (warm sitz baths) can decrease local discomfort. Retinal vein occlusion. Management of delayed cerebral ischemia after subarachnoid hemorrhage. Reactive bleeding. Traditional resuscitation concentrated on the restoration of blood volume with crystalloid solutions in order to increase cardiac output. The method of uterine tamponade using balloons has recently been added to the armamentarium for managing PPH. Crit Care 2016; 20:277. Slides: 28. 2014;23:37-40. Early recognition and a multidisciplinary team approach in the management are the cornerstones of improving the outcome of such cases. tracheostomy or laryngostoma) 2 Respiratory failure: need > 50% FiO 2 Number of Views: 1941. Jin W, Xing Y, Xu Y, Wang W, Yang A. The overall incidence of secondary postpartum haemorrhage in the developed world has been reported as 0.47% – 1.44%.. Blood loss is often underestimated, so it is vital to observe for maternal shock and fetal compromise. Hemorrhage is preventable in many cases with prenatal, labor and delivery, and postnatal interventions. Together, these categories were thought to encompass all of the major areas of disease management, PPT Presentation Summary : Retroclival hemorrhage (rcHage) is rare but can pose a diagnostic dilemma for localization. mostly case reports and case series. mostly post traumatic and in Source : http://3ed3dd2c4fb9ca1daf5c-9d0b22dbad6e71c66e646e96fd7ca8f4.r64.cf2.rackcdn.com/rcHage%20ASNR2016%20eEdE-SKL-final.pptx Thetrue incidence of SAH varies considerably on a geographic basis. Postpartum hemorrhage (PPH) remains a major traumatic event that can occur after delivery. The American Heart Association/American Stroke Association recently published a consensus statement on treatment guidelines for management of symptomatic intracranial hemorrhage (sICH), chaired by Dr. Yaghi. 9/29/2016 3 “An estimated 6.6 million Americans >/= 20 years of age have had a stroke (extrapolated to 2012 by use of NHANES 2009‐2012). The most common cause of secondary PPH is endometritis and/or retained products of conception. Diagnosis – etiology of the bleed. Nurses, Physicians, OR staff, Lab, Blood bank. Abstract. Vitreous hemorrhage has an incidence of seven cases per 100,000, which makes it one of the most common causes of acutely or subacutely decreased vision. Vitreous haemorrhage occurs less commonly following central vein occlusion, since anterior segment neovascularisation is more common … J Glaucoma. The detailed algorithm for management of diabetic vitreous haemorrhage is published elsewhere. 46. death also may occur. 30/09/2004 Decrease maternal mortality 5 Introduction Despite the improved management of primary post partum haemorrhage (PPH). maintenance of tissue perfusion and oxygenation by restoration of blood volume and haemoglobin Massive obstetric hemorrhage is a major cause of maternal mortality and morbidity worldwide. 89 Management … Webinar. Methods—A formal literature search of PubMed was performed through the end of August 2013.The writing committee met by teleconference to discuss narrative text and recommendations. Major haemorrhage can occur in parturients either during the antepartum period, during delivery, or in the postpartum period. CT brain scanning is normal in most patients with sudden headache, but to exclude subarachnoid haemorrhage or other serious disorders, a carefully planned lumbar puncture is also needed. The management protocol shown on the flow chart is, therefore, applicable to the management of postpartum haemorrhage of severe and rapid onset. Treatment of acquired coagulopathy observed in severe PPH is an important part of PPH management, but is mainly based on literature in trauma patients, and data thus should be interpreted with caution. IV access. Birth injuries series #2 Sudden headache is the cardinal feature, but patients might not report the mode of onset. reflections that subarachnoid haemorrhage mayoccur. (2007). Obstet Gynecol. Practitioners need to be aware of the risk factors for postpartum haemorrhage. C, Coker A, Lawal AH, Abu J, Cowen MJ. Overall stroke prevalence during this period is … Anticoagulation In Intracerebral Hemorrhage (ich ... 135846 PPT. Primary postpartum hemorrhage (PPH), defined by the Royal College of Obstetricians and Gynaecologists as bleeding of >500 mL in the first 24 hours of childbirth, 1 complicates 13% of deliveries. This paper aims to help the clinician manage post-extraction haemorrhage. 2. Five cases reported. Introduction. Hemorrhage accounted for 15.25% of all reported maternal mortalities in New York State between 2003 and 2005. Aramark Dietetic Intern. It involves the use of oxytocic medication, immediate cord clamping and delivery of the placenta by controlled cord traction. The bleeding can be minor, such as when the superficial vessels in the skin are damaged, leading to petechiae and ecchymosis. Oral Bleeding Emergency Management Department of Clinical Effectiveness V1 Approved by the Executive Committee of the Medical Staff on 07/21/2020 PRESENTATION 1 Bleeding from the oral cavity, nose, and/or stoma site (e.g. Keywords Postpartum haemorrhage is defined as blood loss of over 500ml following childbirth and is one of the leading direct causes of maternal mortality in the UK. The tamponade test in the management of massive post partum haemorrhage. Perioperative management should therefore focus on optimizing systemic physiology, facilitating timely definitive treatment, and selecting an anesthetic technique based on patient characteristics, severity of aneurysmal subarachnoid hemorrhage, and the planned intervention and monitoring. Appropriate management in all cases of bleeding Massive transfusion protocol (if you have one) Atony Management. Active Management of Third Stage of Labor - Increases risk of postpartum hemorrhage (PPH) 6. Active Management of Third ... Early suckling and postpartum haemorrhage: Controlled trial in deliveries by ... | PowerPoint PPT presentation | free to view Reducing deaths from postpartum haemorrhage Justus Hofmeyr East. Guidelines for the management of postpartum haemorrhage (PPH) involve a stepwise escalation of pharmacological and eventual surgical approaches. Intracerebral hemorrhage (ICH) is the deadliest type of stroke and up to half of patients die in-hospital. Hemorrhage cart/medications. Perioperative management should therefore focus on optimizing systemic physiology, facilitating timely definitive treatment, and selecting an anesthetic technique based on patient characteristics, severity of aneurysmal subarachnoid hemorrhage, and the planned intervention and monitoring. B-Lynch. Appropriate management in all cases of bleeding Early airway protection, control of malignant HTN, urgent reversal … The purpose of this guideline is to facilitate the safe and effective care of a woman by reducing the risk of, and responding promptly and effectively to, a postpartum haemorrhage (PPH) within Auckland District Health Board (Auckland DHB). Abstract and Figures. Abnormal uterine bleeding (AUB) may be acute or chronic and is defined as bleeding from the uterine corpus that is abnormal in regularity, volume, frequency, or duration and occurs in the absence of pregnancy 1 2.Acute AUB refers to an episode of heavy bleeding that, in the opinion of the clinician, is of sufficient quantity to require immediate intervention to prevent further blood loss 1. Hemorrhage is preventable in many cases with prenatal, labor and delivery, and postnatal interventions. Severe trauma often results in uncontrolled, noncompressible diffuse microvascular bleeding, potentially leading to exsanguination; 1, 2 importantly, approximately 40% of all trauma-related deaths are linked to pronounced coagulopathy. Presentation Summary : Anticoagulation in Intracerebral Hemorrhage (ICH) Survivors for Stroke PreventIon and REcovery. Risk Assessment Table: Labor & Delivery Admission and Intrapartum. Care of vulva: Taught to cleanse and wipe vulva from front to back. It is defined (among others) as the loss of >2500 ml of blood, and is associated to a need for admission to critical care and/or hysterectomy. The detailed algorithm for management of diabetic vitreous haemorrhage is published elsewhere. Intracerebral haemorrhage (ICH) is the most devastating and disabling type of stroke. NCT03907046 Major Obstetric haemorrhage (MOH) remains one of the leading causes of maternal mortality & morbidity worldwide. Uncontrolled hypertension (HTN) is the most common cause of spontaneous ICH. Guidelines on the Management of Massive Blood Loss. Hellingman CA, van den Bergh WM, Beijer IS, et al. Find PowerPoint Presentations and Slides using the power of XPowerPoint.com, find free presentations research about Management Of Upper Gastrointestinal Bleeding PPT In the 2003-2005 report of the UK Confidential Enquiries into Maternal Deaths, haemorrhage was the third highest direct cause of maternal death (6.6 deaths/million maternities) with the rate similar to the previous triennium 1, 2. Target audience: All health practitioners providing maternity care and patients. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage. A Guideline for HealthcareProfessionals from the American Heart Association/American Stroke Association. Stroke; 46: 2032-2060. 10 ICH: HEMATOMA EXPANSION RELATED TO ACTIVE BLEEDING THAT MAY PROCEED FOR HOURS AFTER SYMPTOM ONSET TENDS TO OCCUR EARLY INCREASES RISK OF POOR The B-Lynch surgical technique for the control of massive post partum haemorrhage: an alternative to hysterectomy? Management of Postpartum Haemorrhage (PPH) Objectives: To provide advice on the management of postpartum haemorrhage. (2006). Bimanual massage. Transfusion Management of Massive Haemorrhage in Adults Patient bleeding / collapses Ongoing severe bleeding eg: 150 mls/min and Clinical shock Administer Tranexamic Acid – esp in trauma and ideally within 1 hour (1g bolus followed by 1g infusion over 8 hours) Insert local arrangements: Activation Tel Number(s) Emergency O red cells 6. Do you have PowerPoint slides to share? Br J Obstet Gynaecol. Developing evidence-based management strategies for ICH has been hampered by its diverse aetiology, high case fatality and variable cooperative organisation of medical and surgical care. 21 This recommendation is based on observational evidence that haematoma evacuation is associated with decreased mortality, but there is no evidence for improvements in functional outcome. The initial management of any patient with obstetric hemorrhage requires that the obstetrician–gynecologist or other obstetric care provider first identify the source of bleeding (uterine, cervical, vaginal, periurethral, peri-clitoral, perineal, perianal, or rectal). Retinal vein occlusion. The vitreous humor is 99 percent water. Subarachnoid haemorrhage (SAH) is a condition, not a disease, that can be pro-ducedbya multitude ofaetiologies. Active management of the third stage of labour significantly decreases the risk of postpartum haemorrhage. Early recognition and a multidisciplinary team approach in the management are the cornerstones of improving the outcome of such cases. It is the most common cause of pre-mature mortality of women world wide. It is a major cause of obstetric morbidity and mortality worldwide. 2003; 101: 767 –71. Management If there is a clinical suspicion of post-operative bleeding, fast and efficient initial management will reduce overall morbidity and mortality. Bleeding at the time of childbirth remains a common and demanding clinical emergency. Melissa Wolynec. APH occurs in 2-5 per cent of pregnancies and half are of unknown cause. Obstetric haemorrhage is the world’s leading cause of maternal mortality and accounts for an estimated 127,000 deaths each year. Vitreous haemorrhage occurs less commonly following central vein occlusion, since anterior segment neovascularisation is more common … During surgery patients often become relatively hypotensive and vasoconstricted. Active management of PPH is recommended. Secondary postpartum haemorrhage is defined as excessive vaginal bleeding in the period from 24 hours after delivery to twelve weeks postpartum.. In this article, we shall look at the risk factors, clinical features and management of secondary post-partum haemorrhage. If Episiotomy/Laceration repair: Ice pack for 1st several hours to reduce edema and pain. Management. Oct 28, 2020. Delayed PPH, bleeding after 24 hours as a result of sloughing of the placental eschar or retained placental fragments, can also occur. If there is a clinical suspicion of post-operative bleeding, fast and efficient initial management will reduce overall morbidity and mortality. Major haemorrhage can occur in parturients either during the antepartum period, during delivery, or in the postpartum period. 22. This review describes recent advances in transfusion strategy and in the use of tranexamic acid and … Avoiding delays in diagnosis and treatment will have a significant impact on sequelae and chance of survival. The global burden of intracerebral haemorrhage (ICH) is enormous. Treatment approaches to the management of major haemorrhage have transformed during recent decades, based mainly on retrospective evidence. Contemporary approaches emphasize rapid control of bleeding, early management of coagulopathy, maintenance of adequate perfusion, and minimizing the inflammatory response. 1 ST YEAR GUIDED BY: DR. RAJESH K. THAKUR M.D.S. Analysis of the project site British Committee for Standards in Haematology. Poster: Massive Transfusion Protocol (Blood Bank) Poster: Surgical Management. Reactive bleeding refers to bleeding within 24 hours of the operation. The RCOG guideline on prevention and management of postpartum hemorrhage recommends a maximum volume of clear fluids of 3.5 L before the start of blood transfusion, comprising up to 2 L crystalloids and 1.5 L colloids 16. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage. Hemorrhage Management. Recent advances in neuroimaging, organised stroke care, dedicated Neuro-ICUs, medical and surgical management have improved the management of ICH. PPH is one of the leading causes of maternal mortality and morbidity worldwide and accounts for nearly one-quarter of all maternal deaths.15 Multiple studies have suggested that many deaths associated with PPH could be prevented with prompt recognition and more timely and adequate treatment.16-18 Morbi… The curriculum emerged as part of a grant to Pathfinder International from the John D. … Checklist: Hemorrhage Stages 1-4 (Revised September 2020) Checklist: Recommended Instruments (Revised March 2019) Poster: Managing Maternal Hemorrhage. Activate response team. Free Download Classification and management of wound principle of bleeding control PowerPoint Presentation. Prevention, recognition, and ManageMent of PPH Prevention, recognition, and ManageMent of PPH iii Acknowledgements The development of the training curriculum Prevention, Identification and Management of Postpartum Hemorrhage is the result of collaboration between many individuals and organizations. 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