University:
University of Nottingham
Course:
B723 | Midwifery
Academic year:

2024
Views:

243

Pages:

4
Author:

Christy C.

REFERRAL MEASURES FOR PATIENTS WITH ANTEPARTUM HEMORRHAGE (SKILLS IN THE COMMUNITY) STUDY PROGRAM tools preparation STEPS / ACTIVITIES Speculum Stethoscope Thermometer Tensiometer 3 cc syringe Infusion set and liquid gloves Personal Protective Equipment (PPD) Blood (if necessary) Small towel / tissue Sterile and non-sterile instrument tubs. Plaster Plaster scissors Hypafix Standard infusion Catheter Bent Kom contains cotton with DTT Doppler water Lamp and basin containing 0.5% Cl solution Implementation 1 Provide an explanation to the patient or family about the current condition and ask for approval for medical treatment 2 Use personal protective equipment 3 Wash your hands 7 steps under running water and use soap 4 Dry your hands with a personal towel by wiping each side of the towel once or using a tissue 5 Use clean gloves 6 Ascertain the indications, signs and symptoms of antepartum hemorrhage Placental abruption: Occurs at gestational age > 28 weeks until before labor Bleeding with pain occurs due to sudden trauma Placenta Previa Occurs at gestational age > 28 weeks. Bleeding is repeated and slow No pain Not preceded by trauma 7 Perform a physical examination, vital signs (DJJ and Leopold) Placental Abruption The general condition is not consistent with bleeding Anemic Vital signs are inconsistent with bleeding. Bleeding accompanied by PER or eclampsia. Abdomen is tense Painful Fetal parts are difficult to touch Abnormal DJJ (fetal distress up to death) and difficult to hear Blood color is darker (blackish) Placenta Previa The general condition is consistent with bleeding Soft abdomen No pain The baby experiences fetal distress. The blood is fresh red The lowest part of the fetus has not entered the PAP (upper pelvic outlet) 8 Position the mother in the lithotomy position 9 Change to sterile gloves 10 Perform a speculum examination (do not do an internal examination) for placenta previa, bleeding originating from the external uterine ostium. 11 Explain the results of the examination and the actions that will be taken to the mother if possible or the family 12 Communicate preparations referring to the family 13 Install an infusion if necessary, install two lines 14 Check your blood type and prepare a blood donor for a transfusion 15 Make a referral by continuing to observe the condition of the mother and DJJ, they must be accompanied and bring a referral letter 16 Provide information to the referral place about the results of the examination that has been carried out