Launching Obstetric ALERT

Dr Helen PeetConsultant in Critical Care and

Anaesthesia Portsmouth Hospitals NHS Trust

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Obstetric Critical Care

• Maternal mortality continues to fall• For every death there are at least 10 cases of significant morbidity• Influenza

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A Personal Perspective

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Just a few slides….

• And a few more• … a bit of consulting• … some bribery • … a new manual• …and a new symbol

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Aims of the Obstetric Aims of the Obstetric ALERTALERTTMTM Course Course

• Identification of the at risk obstetric patientIdentification of the at risk obstetric patient• Appropriate management of acutely ill women Appropriate management of acutely ill women

and prompt escalation of careand prompt escalation of care• Improved team working and communicationImproved team working and communication• Avoidance of preventable maternal harm and Avoidance of preventable maternal harm and

deathdeath• Prioritisation of maternal wellbeing over fetal Prioritisation of maternal wellbeing over fetal

wellbeingwellbeing

Learning ObjectivesLearning Objectives

• Understand the systematic assessment Understand the systematic assessment • Recognise when to call for helpRecognise when to call for help• Understand the simple interventions and Understand the simple interventions and

monitoring required monitoring required • Understand the importance of clear Understand the importance of clear

communication and documentationcommunication and documentation

Course Structure

• Sepsis features highly• ALERT system of assessment• Recognition of different audience• More emphasis on group work and workshops• Recognition of 2 patient problem but

emphasis on maternal welfare• Sepsis features highly

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Course Contents

• Same system of assessment• Incorporation of “F” into assessment• Continues to stress recognition of life

threatening emergencies• General topics adapted for obstetrics • Obstetric specific topics discussed

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The ALERTThe ALERTTMTM System of Assessment System of Assessment

Immediate AssessmentImmediate Assessment

AirwayAirway

BreathingBreathing

CirculationCirculation

DisabilityDisability

ExposureExposure

FetusFetus

Scenarios

•Eclampsia•Hypoglycaemia•Sepsis•MOH•PE•Anaphylaxis

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Faculty Demonstration

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Questions

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Food for thought

The reviews clearly illustrate that timely recognition of risk, the severity of the condition, accurate diagnosis, involvement of the correct senior staff from multiple disciplines, escalation and prompt treatment and action can make the difference between life and death.Knight M, Kenyon S, Brocklehurst P, Neilson J, Shakespeare J, Kurinczuk JJ (Eds.) on behalf of MBRRACE-UK. Saving Lives, Improving Mothers’ Care - Lessons learned to inform future maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009–12.

Oxford: National Perinatal Epidemiology Unit, University of Oxford 2014.

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