ABC and maternal resuscitation
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![Page 1: ABC and maternal resuscitation](https://reader030.fdocuments.us/reader030/viewer/2022032709/56813198550346895d980c0b/html5/thumbnails/1.jpg)
ABC and maternal resuscitation
![Page 2: ABC and maternal resuscitation](https://reader030.fdocuments.us/reader030/viewer/2022032709/56813198550346895d980c0b/html5/thumbnails/2.jpg)
Aims
• Understand primary survey
• Airway, Breathing, Circulation, Disability
• Assess and treat in this order
• To develop and gain competence in the skills needed for maternal Cardio-pulmonary Resuscitation
![Page 3: ABC and maternal resuscitation](https://reader030.fdocuments.us/reader030/viewer/2022032709/56813198550346895d980c0b/html5/thumbnails/3.jpg)
Airway, Breathing Circulation
• Why in this order?
• Assess and treat each before progressing onto the next
![Page 4: ABC and maternal resuscitation](https://reader030.fdocuments.us/reader030/viewer/2022032709/56813198550346895d980c0b/html5/thumbnails/4.jpg)
Ensure safety
• Make sure you are not endangering yourself first
• Is it safe to approach the patient?
![Page 5: ABC and maternal resuscitation](https://reader030.fdocuments.us/reader030/viewer/2022032709/56813198550346895d980c0b/html5/thumbnails/5.jpg)
First of all….
• Is the patient just asleep?
• Shake and Shout! (remember they might be deaf!)
![Page 6: ABC and maternal resuscitation](https://reader030.fdocuments.us/reader030/viewer/2022032709/56813198550346895d980c0b/html5/thumbnails/6.jpg)
Call for help
• Place patient in tilt, preferably left lateral, 15 to 30 degrees
![Page 7: ABC and maternal resuscitation](https://reader030.fdocuments.us/reader030/viewer/2022032709/56813198550346895d980c0b/html5/thumbnails/7.jpg)
Assessment
• Airway:
• LOOK for chest movement
• LISTEN for breath sounds, noisy or quiet
• FEEL
![Page 8: ABC and maternal resuscitation](https://reader030.fdocuments.us/reader030/viewer/2022032709/56813198550346895d980c0b/html5/thumbnails/8.jpg)
Airway
• Absent or noisy breath sounds?
• Open airway
• Head tilt and chin lift or jaw thrust
![Page 9: ABC and maternal resuscitation](https://reader030.fdocuments.us/reader030/viewer/2022032709/56813198550346895d980c0b/html5/thumbnails/9.jpg)
Maintain airway
• Measure for and insert Guedel’s airway
![Page 10: ABC and maternal resuscitation](https://reader030.fdocuments.us/reader030/viewer/2022032709/56813198550346895d980c0b/html5/thumbnails/10.jpg)
Breathing
• Is the patient breathing?
• What is the respiratory rate?
• Too fast or two slow, treat with oxygen
![Page 11: ABC and maternal resuscitation](https://reader030.fdocuments.us/reader030/viewer/2022032709/56813198550346895d980c0b/html5/thumbnails/11.jpg)
Circulation
• Pulse high?
• Blood Pressure low?
• Skin cold, hot, sweaty?
• Conscious level Aggressive, not alert?
• Fetal heart fast, slow, absent?
• Urine output reduced?
• Colour pale, grey?
![Page 12: ABC and maternal resuscitation](https://reader030.fdocuments.us/reader030/viewer/2022032709/56813198550346895d980c0b/html5/thumbnails/12.jpg)
Circulation
• Insert two wide bore lines
• Take bloods
• Give fluids
• Think: Why is there a C problem?
• Secondary survey and treat cause
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If not breathing.......
• Assume cardiac arrest, unless cessation of breathing observed
• Commence CPR
• 100-120/minute
• 30/2 compressions to
breaths
![Page 14: ABC and maternal resuscitation](https://reader030.fdocuments.us/reader030/viewer/2022032709/56813198550346895d980c0b/html5/thumbnails/14.jpg)
Chest compressions
• Place heel of hand on lower part of sternum
• Place other hand on top and lock fingers• Keep arms straight, lean from shoulders• Depress sternum by 5-6 cms• Rate 120/minute• Very tiring, take turns if possible• 30:2 compressions to breaths
![Page 15: ABC and maternal resuscitation](https://reader030.fdocuments.us/reader030/viewer/2022032709/56813198550346895d980c0b/html5/thumbnails/15.jpg)
Reassess
• Has the cause for the arrest been addressed?
• When to stop?
• Consider peri-mortem caesarean section
• Intended to save mother
• Bloodless procedure, do there and then, mother is dead anyway if you don’t
![Page 16: ABC and maternal resuscitation](https://reader030.fdocuments.us/reader030/viewer/2022032709/56813198550346895d980c0b/html5/thumbnails/16.jpg)
Any questions?
![Page 17: ABC and maternal resuscitation](https://reader030.fdocuments.us/reader030/viewer/2022032709/56813198550346895d980c0b/html5/thumbnails/17.jpg)
Recap
• Assess and treat A then B then C
• TILT patient
• Always ensure open airway
• Give Oxygen if available
• Establish IV lines
• Secondary survey