Obs - ALSO Mnemonics.txt

Card Set Information

Author:
dohertys
ID:
131322
Filename:
Obs - ALSO Mnemonics.txt
Updated:
2013-01-22 22:14:09
Tags:
obstetrics
Folders:

Description:
obstetrics
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user dohertys on FreezingBlue Flashcards. What would you like to do?


  1. ALSO
  2. Fetal Surveillance Mnenonic
    DR C BRAVADO
  3. Shoulder Dystocia Mnemonic
    HELPERR
  4. Mnemonic for Causes of PPH
    • 4 T's
    • Tone (Uterine atony)
    • Trauma (Cervical or vaginal)
    • Tissue (Retained placenta)
    • Thrombin (Coagulopathy)
  5. Approach to Mgmt of Massive PPH
    • Head
    • Arms
    • Uterus (start at uterus)
  6. Mnemonic for Forceps Application
    ABCDEFGHIJ
  7. Mnemonic for Vacuum Application
    ABCDEFGHIJ
  8. DR C BRAVADO
    • DR - define risk
    • C - contractions
    • BRa - baseline rate - Normal 110-160
    • Variability
    • Accelerations
    • Decelerations
    • Overall
  9. What does DR stand for in DR C BRAVADO?
    Define Risk - high or low
  10. What is C in DR C BRAVADO?
    C is Contractions - comment on frequency, etc
  11. What is BRa in DR C BRAVADO?
    Baseline RAte - bradycardia, normal 110-160 or tacky
  12. What is V in DR C BRAVADO?
    Variability - at least 10-15 bpm (persistent, reduced variability is a particularly ominous sign)
  13. What is A in DR C BRAVADO?
    Accelerations - present or absent (at least 15bpm rise from baseline lasting at least 15 seconds)
  14. What is DR C BRa V A in DR C BRAVADO?
    • DR - define risk
    • C - contractions
    • BRa - Baseline Rate
    • V - Variability
    • A - Accelerations
  15. What is remaining D and O in DR C BRAVADO?
    • Decelerations - early, variable or late
    • Overall - assess as reassuring or nonreassuring and plan
  16. What is criteria for intermittent Auscultation?
    • Healthy women with uncomplicated pregnancy
    • During active labour, should occur after a contraction x 1 min q15min in 1st stage and q5min in 2nd stage
  17. What are things that would require change to continuous auscultation?
    If NST/auscultation is non-reassuring - bradycardia, tackycardia, decelerations or other intrapartum risk factors develop
  18. Normal baseline rate?
    110-160
  19. Normal variability
    At least 10-15 bpm
  20. Normal Accelerations
    at least ≥15 beat rise x ≥15 seconds
  21. Normal decelerations
    Earlys are okay
  22. Overall assessment
    Reassuring vs Non-Reassuring
  23. What are causes of early decelerations?
    Head compression
  24. What is the intervention for early decelerations?
    None
  25. What is the causes of variable decelerations?
    Cord compression
  26. What is the intervention for variable decelerations?
    Amnioinfusion, reposition mother
  27. How do you do an amnioinfusion for variable decels?
    Infuse 250-500cc warm saline through intra-uterine pressure catheter and follow with 50-60cc/h drip
  28. What is the cause of late decelerations?
    Uteroplacental insufficiency
  29. Intervention for late decelerations?
    Stop oxytocin, give oxygen
  30. What is the Mnemonic for Shoulder Dystocia?
    HELPERR
  31. What is each stand for in HELPERR?
    • H - call for Help
    • E - Evaluate for Episiotomy
    • L - Legs - mcroberts maneuver
    • P - external Pressure
    • E - Enter: rotational maneuvers
    • R - Remove posterior arm
    • R - Roll patient to her hands and knees
  32. What is H-E-L of HELPERR?
    • H - Help - call for HELP
    • E - Evaluate for Episiotomy
    • L - Legs - McRoberts (knees to chest with supraopubic pressure)
  33. What is P-E-R-R of HELPERR?
    • P - Pressure - External Pressure (suprapubic pressure)
    • E - Enter - rotational maneuvers
    • R - Remove - remove posterior arm
    • R - Roll onto hand and knees
  34. What is HELPERR (1 word for each)?
    • Help
    • Eval/Episiotomy
    • Legs
    • Pressure
    • Enter
    • Remove
    • Roll
  35. How to do McRoberts Maneuver for Shoulder Dystocia?
    Legs - knees to chest and combine with Pressure - suprapubic pressure
  36. 3 different 'Enter' maneuvers?
    • Rubin II
    • Rubin II + Wood's Screw
    • Reverse Wood's Screw
  37. How to remove the posterior arm?
    • Follow the posterior arm to the elbow
    • Flex arm at elbow
    • Sweep forearm across chest without pulling directly on hand
  38. Mgmt of Massive PPH - how to organize the team
    • Helper 1 @ Head
    • Helper 2 and 3 @ Arms
    • Leader at Uterus (start here)
  39. What does Uterus person do PPH?
    • Start here - call for help
    • massage uterus to stimulate contraction
    • Coordinate helper 1 to head and helpers 2 and 3 to arms
    • If bladder full or palpable - empty with catheter
    • If atony persists - bimanual compression
    • Review 4 T's of PPH
    • Move to surgery if bleeding persists
  40. What does helper 1 @ head do for PPH?
    • Check airway
    • Check breathing
    • Admin O2
    • Lie flat
    • Not time of relevant events
  41. What do helpers 2 and 3 do at arms for PPH?
    • Check pulse and bp
    • Large bore IV x 2
    • Check blood counts, clotting and crossmatch 4-6 units
    • Fluid resuscitation PRN w 2L crystalloid
    • Drugs admin
  42. What drugs can be administered for PPH?
    • Oxytocin/Syntocinon
    • Methylergonovine/Ergometrine (if avail)
    • Prostaglandin F2alpha (consider surgery if >2 doses needed)
  43. PPH - Manual maneuvers for uterine atony?
    • Bimanual massage and compression
    • Intramyometrial prostaglandin injection
  44. PPH - Manual maneuvers for retained placenta
    • Manual extraction
    • Exploration for fragments
  45. PPH - Manual maneuvers for uterine inversion
    • Recogion
    • Replacement (push back with hand)
    • Restitution (ensure fundus is restored)
  46. Doses of Meds for PPH due to Atony
    • 1) Oxytocin/Syntocinon - 10U IV or IM. 10-40U in 1L NS @ 250cc/h
    • 2) Methylergonovine 0.2mg IM or Ergometrine 0.5mg IM
    • 3) Prostaglandin F2alpha 0.25mg IM or intramyometrial (repeat q15 min up to 8 doses but consider surgery after 2 doses)
  47. What percentage of PPH are caused by each of the 4 T's
    • Tone - 70% of cases
    • Trauma - 20% of cases
    • Tissue - 10% of cases
    • Coagulopathy - 1%
  48. Mnemonic for Forceps application
    • A - address the patient, ask for help, anesthesia adequate?
    • B - bladder empty?
    • C - cervix must be completely dilated
    • D - determine position of head - think of shoulder dystocia
    • E - Equipment ready
    • F - Forceps ready
    • G - Gentle traction
    • H - Handle elevated to follow the j shaped pelvic curve
    • I - Incision - evaluate for a possible episiotomy when the perineum distends
    • J - Remove forceps when Jaw is reachable
  49. A to C of mnemonic for Forceps use
    • A - address the patient, ask for help, anesthesia adequate?
    • B - bladder empty?
    • C - cervix must be completely dilated
  50. D to F of mnemonic for Forceps use
    • D - determine position of head - think of shoulder dystocia
    • E - Equipment ready
    • F - Forceps ready
  51. G to J of Forceps mnemonic
    • G - Gentle traction
    • H - Handle elevated to follow the j shaped pelvic curve
    • I - Evaluate for Incision for a possible episiotomy when the perineum distends
    • J - Remove forceps when Jaw is reachable
  52. Mnemonic for Vacuum Application
    ABCDEFGHIJ - all except E, F, G, H are the same
  53. Whole mnemonic for Vacuum use?
    • A - address the patient, ask for help, anesthesia adequate?
    • B - bladder empty?
    • C - cervix must be completely dilated
    • D - determine position of head - think of shoulder dystocia
    • E - Equipment ready, extractor ready
    • F - place cup in proper relation to Fontanelles on Flexion point
    • G - Gentle traction following pelvic curve, rising as head crowns
    • H - Halt traction b/w contractions, Halt procedure if cup disengages 3 times, halt if no progress in 3 pulls, halt after 20 min of use (be prepared to abandon and go to C/S)
    • I - Incision - evaluate for a possible episiotomy when the head is crowning
    • J - Remove vacuum when Jaw is reachable

What would you like to do?

Home > Flashcards > Print Preview