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Managing Medical and Obstetric Emergencies and Trauma
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Вернуться на страницу книги Managing Medical and Obstetric Emergencies and Trauma
Оглавление
Страница 1
Table of Contents
List of Tables
List of Illustrations
Guide
Pages
Managing Medical and Obstetric Emergencies and Trauma A Practical Approach
Страница 8
Dedication
Working group for third edition
Страница 11
Foreword to fourth edition
Preface to fourth edition
Acknowledgements
Страница 15
Страница 16
Abbreviations
Страница 18
Страница 19
CHAPTER 2 Saving mothers’ lives: lessons from the Confidential Enquiries 2.1 Introduction
2.2 How the enquiries work
Reporting
Expert assessment
Reports
2.3 Lessons from the past Effective intervention
Obstetric injury
2.4 Recent lessons Obstetric injury today
Who is at risk?
Age
Obesity
Socioeconomic classification
Ethnicity
2.5 Direct deaths Hypertensive disease
Haemorrhage
Thromboembolism
Ectopic pregnancy
Abortion
Amniotic fluid embolism
Sepsis
Anaesthesia
2.6 Indirect deaths
Cardiac disease
Mental health conditions
Other indirect deaths
2.7 Coincidental deaths
2.8 Quality of care
2.9 The international dimension
2.10 Summary
2.11 Further reading
Страница 50
CHAPTER 4 Human factors Learning outcomes
4.1 Introduction
4.2 Extent of healthcare error
4.3 Causes of healthcare error
4.4 Human error
4.5 Learning from error
Improving team and individual performance
4.6 Communication
Effective communication with a feedback loop
4.7 Team working, leadership and followership
The leader
Who is the leader?
Physical position of the leader
Clear roles
Followership
Hierarchy
4.8 Situation (or situational) awareness
Level 1 – the basic level (What is going on? Collecting information)
Distraction
Level 2 (So what? Interpreting the information)
Level 3 (Now what? Anticipating the future state)
Team situation awareness
4.9 Improving team and individual performance
Awareness of situations when errors are more likely
Awareness of error traps
Cognitive aids: checklists, guidelines and protocols
Calling for help early
Using all available resources
Debriefing
4.10 Summary
4.11 Further reading
Страница 82
CHAPTER 5 Recognising the seriously sick patient
Learning outcomes
5.1 Introduction
5.2 Modified early‐warning systems
Box 5.1
SBAR
Breathlessness
Headache
Abdominal pain and diarrhoea
5.3 Summary
5.4 Further reading
Appendix 5.1 Blood gas interpretation Lactate
ABG interpretation
Appendix 5.2 Radiology in the pregnant woman
CHAPTER 6 Shock
Learning outcomes
6.1 Introduction
6.2 Aortocaval compression and supine hypotension syndrome
6.3 Types of shock
Hypovolaemic shock: insufficient preload
Absolute hypovolaemia – blood loss, fluid loss
Important implications of pregnancy physiology in haemorrhage
Relative hypovolaemia – vasodilatation due to regional blockade
Cardiogenic shock – reduced cardiac contractility
Distributive shock – abnormal vascular resistance and fluid distribution
Sepsis
Anaphylaxis
Burns
Obstructive shock
6.4 Symptoms and signs of shock
Hypovolaemic shock
Increase in heart rate
Skin, capillary refill, mental state and urine output
Capillary refill time (CRT)
Mental state
Narrowed pulse pressure
Systolic hypotension
Recognition of hypovolaemia
Pitfalls in the recognition of shock in pregnancy
6.5 Principles of treatment Hypovolaemic shock
C: Circulation
Septic shock
Cardiogenic shock
Anaphylactic shock
Box 6.1
Management of anaphylactic shock
6.6 Summary
6.7 Further reading
CHAPTER 7 Sepsis
Learning outcomes
7.1 Introduction and definition
7.2 Sepsis in pregnancy
Box 7.1
Classification of maternal infection aligned with the WHO classification of maternal death
7.3 Pathophysiology of sepsis
Clinical manifestations of haemodynamic alterations
7.4 Microbiology
7.5 Clinical issues and presentation
7.6 Monitoring, investigations and urgent treatment
Airway and breathing
Fluids
Vasopressors
Early source identification and control of infection
Influenza A/H1N1
Treatment
Recommendations
SARS‐CoV‐2
Treatment
7.7 Summary
7.8 Further reading
Appendix 7.1 Viral rash in pregnancy
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