ABCDE Acronym Blood Transfusion 231 Major Trauma 234 Maternal

Home , Amniotic fluid embolism, Locked twins, Umbilical cord prolapse

Cambridge University Press 978-0-521-26827-1 - Obstetric and Intrapartum Emergencies: A Practical Guide to Management Edwin Chandraharan and Sir Sabaratnam Arulkumaran Index More information

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ABCDE acronym albumin, blood plasma levels 7 arterial blood gas (ABG) 188 blood transfusion 231 allergic anaphylaxis 229 arterio-venous occlusions 166–167 major trauma 234 maternal collapse 12, 130–131 amiadarone, overdose 178 aspiration 10, 246 newborn infant 241 amniocentesis 234 aspirin 26, 180–181 resuscitation 127–131 amniotic fluid embolism 48–51 assisted reproduction 93 abdomen caesarean section 257 asthma 4, 150, 151, 152, 185 examination after trauma 234 massive haemorrhage 33 pain in pregnancy 154–160, 161 maternal collapse 10, 13, 128 atracurium, drug reactions 231 accreta, placenta 250, 252, 255 anaemia, physiological 1, 7 atrial fibrillation 205 ACE inhibitors, overdose 178 anaerobic metabolism 242 automated external defibrillator (AED) 12 acid–base analysis 104 anaesthesia. See general anaesthesia awareness under anaesthesia 215, 217 acidosis 94, 180–181, 186, 242 anal incontinence 138–139 ACTH levels 210 analgesia 11, 100, 218 barbiturates, overdose 178 activated charcoal 177, 180–181 anaphylaxis 11, 227–228, 229–231 behaviour/beliefs, psychiatric activated partial thromboplastin time antacid prophylaxis 217 emergencies 172 (APTT) 19, 21 antenatal screening, DVT 16 benign intracranial hypertension 166 activated protein C 46 antepartum haemorrhage 33, 93–94. benzodiazepines, overdose 178 Addison’s disease 208–209 See also massive obstetric beta-blockers 183, 206–207 adrenal gland 3, 208–210 haemorrhage beta-haemolytic Strep Lancefield adrenaline 130 anterior ventouse cups 103 group A 41 Adult Life Support (ALS) guidelines antibiotics 152 black/ethnic minorities 49 236 caesarean section 109–110 bladder injury, CS 116, 118 drug overdose 178 Adult Respiratory Distress Syndrome major trauma 237 blindness 166–167.Seealsovisual (ARDS) 43 MAP 252 problems advanced life support 12–13, 228 see also sepsis/septic shock blood gases 2, 188 AED (automated external defibrillator) anticoagulants, 21, 178 blood pressure 2 12 antihistamines, overdose 178 amniotic fluid embolism 50 AFE. See amniotic fluid embolism drug overdose 181, 182 anxiety 170, 172, 173 postpartum haemorrhage 39 AFLP (acute fatty liver of pregnancy) abdominal pain 154 preeclampsia/eclampsia 25, 26, 158 palpitations 145, 148 27–28 airbags, vehicle 238 aortocaval compression 9 sepsis/septic shock 44 airway Apgar scores 215, 267 visual problems 166 amniotic fluid embolism 49 appearance, assessment 172 blood sugar diabetic ketoacidosis 186 diabetic ketoacidosis 185–190 drug overdose 177 appendicitis 5–7, 158–159 drug overdose 180 general anaesthesia 216 APTT (activated partial hypopituitarism 212 major trauma 235 thromboplastin time) 19, 21 see also glucose metabolism maternal collapse 12, 130 blood transfusion. See transfusion newborn infant 241–242, 243–244 ARDS (Adult Respiratory Distress sepsis/septic shock 43 Syndrome) 43 blood volume 1, 4, 7

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© in this web service Cambridge University Press www.cambridge.org Cambridge University Press 978-0-521-26827-1 - Obstetric and Intrapartum Emergencies: A Practical Guide to Management Edwin Chandraharan and Sir Sabaratnam Arulkumaran Index More information

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blunt trauma 233, 234 cardiovascular system 1–2, 5, 6, 9, 128, constipation 4 blurred vision 164, 165, 166–167.See 205, 215 convulsions 4, 28, 191–195, 196, 197 also visual problems care bundles 272 cord. See umbilical cord bone fractures 201, 202–203 case study, fluid underload 225 cornea 164 bowel injury, CS 116, 118 cauda equina syndrome 198–200 corticosteroids 185 breathing CEMACE (Centre for Maternal and cortisol 210.Seealsoacute adrenal amniotic fluid embolism 49 Child Enquiries) 44–46, 265, 270, insufficiency diabetic ketoacidosis 186 271 cricothyroidotomy 218, 219 drug overdose 177 central nervous system 205 major trauma 235 CT scanning 212 maternal collapse 12, 130 central serous retinopathy 166 CTG (cardiotocography) 78–85 neonatal 241–242, 244–245 central venous pressure 223 sepsis/septic shock 43 CTPA (pulmonary angiogram) 19 cerebral palsy 78, 93 breathlessness during pregnancy cyclizine 231 150–153 cervical spine control, trauma 235 breech delivery 59–60, 61, 62, 63, 64, chest compressions 256 DDI (decision to delivery intervals) 65, 66 cholecystitis, acute 158 107 twins 93 cholinesterase deficiency 215 De Lee incision 111 umbilical cord prolapse 68 chorioamnionitis 157 debriefing, postnatal 113 bromocriptine, overdose 178 choroidal changes 165 decontamination, drug 177, 183–184 burns 234 circulation 186 deep vein thrombosis/venous Burns–Marshall manoeuvre 64 amniotic fluid embolism 49 thromboembolism 7, 11, 15, 19, drug overdose 177 22 caesarean section (CS) 98–99 major trauma 235–236 caesarean section 108, 257 awareness 215 maternal collapse 12, 130 maternal collapse 10 breech delivery 65 neonatal 245 preeclampsia 25, 28, 31 complications 115–119 sepsis/septic shock 44 de-escalation 174 emergency 107–114 peri/postmortem 10, 13, 112–113, citrate toxicity 228 defibrillation 12, 130 256–258 CICV (can’t intubate can’t ventilate) definitions calcium channel blockers 182, 218 amniotic fluid embolism 48 207 clamping, umbilical cord 243 blood transfusion reactions 227 breathlessness 150 calcium supplements 26 classical incision, CS 111 breech delivery 59 can’t intubate can’t ventilate (CICV) Clinical Negligence Scheme for Trusts caesarean section 107, 256 218 (CNST) 272 convulsions/epilepsy 191 caput succedaneum 100 deep vein thrombosis 15 clonidine, overdose 178 diabetic ketoacidosis 185 carboprost, drug reactions 231 Clostridium septicum 41 drug reactions 231 cardiac arrest 9, 130, 256–258, coagulation 1 failed intubation 214 270 fire drills, labour ward 260 coagulopathy 228 fluid management 221 cardiac arrhythmias 145, 181.Seealso Code Blue protocol 33, 36, 116 instrumental delivery 98 palpitations massive obstetric haemorrhage cognitive function 173 cardiac disease 33 breathlessness 152 colestyramine 207 maternal collapse 9, 126 caesarean section 257 colour, neonate 242 morbidly adherent placenta 250 preeclampsia/eclampsia 24 general anaesthesia 215 colour flow ultrasound 250 fluid management 222, 224 psychiatric emergencies 170 maternal collapse 10 compression sutures 38 pulmonary embolism 15 palpitations 146–147 retained placenta 132 congenital problems 246 risk management 269 cardiac failure 150, 225 congestive heart failure 205 sepsis/septic shock 41 Cardiff wedge 9 conjoined twins 96 shoulder dystocia 88 umbilical cord prolapse 68 cardiotocography (CTG) 78–85 consent, informed 100, 109, 215, 257 venous thromboembolism 15

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dehydration. See fluid management eclampsia 29–30.Seealsopreeclampsia fetal implications delayed haemolytic reactions 227 ectopic pregnancy 154–155 amniotic fluid embolism 48 blood transfusion 228, 230 delirium 170, 172, 173 electrocardiogram (ECG) 2, 146, 181 breathlessness 150 delivery electrolytes, DKA 188 breech delivery 59–60, 61 caesarean section 108–109, 115 amniotic fluid embolism 50 Elliot forceps 65 analgesia 11 convulsions/epilepsy 192 anticoagulants 21 Elschnig’s spots 165 deep vein thrombosis 15–16 perineal trauma 142 emergency treatment, general diabetic ketoacidosis 185, 187 preeclampsia/eclampsia 28–29, anaesthesia 215, 219 drug overdose 176 31 fluid management 221–222 see also breech delivery; caesarean emotional lability 170 general anaesthesia 214–215 section; instrumental vaginal endocrine emergencies 204 imaging 154 delivery; twin delivery adrenal insufficiency 208–210 instrumental vaginal delivery 98–99, 104 delusions 170 hypopituitarism 211–213 myxoedema coma 207–208 major trauma 233, 236 depression 170, 172 phaeochromocytoma crisis 210–211 maternal collapse 126 desmopressin 213 thyroid storm 204–207 morbidly adherent placenta 250 myxoedemacoma207 dexamethasone 206–207, 213 endocrine system 3–6, 7 preeclampsia 25, 27 diabetes 167–168 endotracheal intubation 10 psychiatric emergencies 170, epidural anaesthetic 11–12 173 diabetic ketoacidosis 185–190 sepsis/septic shock 42, 43 dialysis, peritoneal 207 epigastric blood vessels 117–118 shoulder dystocia 88 differential diagnoses epilepsy 4, 28, 191–195, 196, 197 simulation training 265 abdominal pain thyroid storm 204 episiotomy 62, 90, 138, 140, 142.See twins 93–94 amniotic fluid embolism 50 also perineal trauma convulsions/epilepsy 192–193 umbilical cord prolapse 68 fluid management 225 ethnic minorities 49 uterine rupture 52 palpitations 146 equipment feto-maternal haemorrhage (FMH) psychiatric emergencies 170, 172, fire drills 261–262 237.Seealsohaemorrhage 173 resuscitation 242 fibrillations 145 digoxin overdose 181–182 ergometrine 37 fibrinolysis 1 disability 236.SeealsoABCDE ergotamine overdose 178 fibroids 156 acronym Escherichia coli 41 fidelity simulation training 264 diuretics 223 esmolol 206–207 Finkelstein’s test 198 dizziness 145, 148 European Working Time Directive fire drills 260–263 documentation, AFE 50–51 215, 265 fistulograms 234 domestic violence 238 exposure. See ABCDE acronym flexion point 103, 104 Doppler ultrasound 25, 94, 237, 250 eye disease 168.Seealsovisual problems fluid management 221–225 double vision 165 diabetic ketoacidosis 186 drooping eyelid 163 Faber’s test 198 major trauma 234 preeclampsia/eclampsia 28 drugs faecal incontinence 138–139 maternal collapse 128 fluid resuscitation 187–188 overdose 176–178, 184 Failure Mode and Effects Analysis (FMEA) 273 focused abdominal sonography for resuscitation, neonatal 245–246 trauma (FAST) 235 teratogenicity 192 fatty liver of pregnancy, acute (AFLP) toxicity 11–12 158 FORCEPS acronym 99–100 transfusion reactions 231–232 febrile immune reactions 227–228 forceps delivery 64–65, 99, 100, 101–102 Early Warning Score, maternal collapse feedback, risk management 273 fractures 201, 202–203 127 fetal compromise 78–79, 81, 82, 83, 84, ecbolics 37 85, 86 gallbladder 4 echocardiography 2, 19, 147 fetal head positioning 99, 112, 115, 116 gall stones 158

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gastric decontamination, drug heart rate monitoring 78–85, 242 immunisation, tetanus 237 overdose 177, 181 HELLP (Haemolysis, Elevated Liver increta, placenta 250 gastritis 156 enzymes, Low Platelets) syndrome infection 186, 222, 228 25, 30, 157–158 gastrointestinal system 3, 5, 6 inferior vena cava shunt 21–22 appendicitis 5–7 heparin 20–21, 28, 152 information for patients, DVT 16 constipation 4 hepatitis 159, 228 intestinal obstruction 159 informed consent 100, 109, 215, 257 sepsis/septic shock 43 HIE (hypoxic ischaemic thyroid storm 205 encephalopathy) 267 insight 173 general anaesthesia 214–219 high myopia 168–169 instrumental vaginal delivery 98, 99, 100, 101, 102, 103, 104, 106 caesarean section 108, 109, 114 history-taking maternal collapse 128 general anaesthesia 215 insulin 187–188, 189 uterine inversion 123 psychiatric emergencies 172 insulin resistance 185 gestational transient thyrotoxicosis 206 Huntingdon’s operation 123 intensivecare50 Glasgow Coma Scale 130, 186, 236 hydralazine 28 intestinal obstruction 159 glucocorticoids 206–207 hydrocortisone 206–207, 209, 212 intracerebral tumours 168 glucose metabolism 3, 7.Seealsoblood hydrostatic reduction 122 intracranial haemorrhage 11 sugar hyper-coagulable states 1 intubation glycosuria 7 hyperemesis gravidarum 206 endotracheal 10 Graves’ disease 168, 204 failed 218–219 hyperglycaemia. See blood sugar guidelines major trauma 234 major trauma 236 hyperkalaemia 11, 181–182, 228 inversion, uterine 120–124, 128 maternal collapse 127 hypertension. See blood pressure iodides 206 NICE 81, 272 hyperthermia. See temperature resuscitation 245, 247–248 iodine 207 RCOG 272 hyperventilation 173 iron overdose 183–184 Surviving Sepsis Campaign 44–46 hypoglycaemia. See blood sugar gum elastic bougie 219 hyponatraemia 208 Joel Cohen incision 110 gunshot injury 234 hypopituitarism 211–213 Johnson’s manoeuvre 122

haematology1,4,5,6,43 hypotension. See blood pressure ketoacidosis, diabetic 185–190 haemodialysis 184 hypothermia 11, 216, 228, 243.See knee–chest position 70 temperature; myxoedema coma Haemolysis, Elevated Liver enzymes, hyperthermia labetalol 27 Low Platelets (HELLP syndrome) 25, 30, 157–158 hypovolaemia 11, 225 labour. See delivery haemolytic immune reactions 227 hypoxia 9–10, 11, 82 laparoscopy 234 fetal compromise 78–79, 81, 82, 83, haemorrhage 4 84, 85, 86 laparotomy 234 caesarean section 108, 115, 116 general anaesthesia 215 lateral tilt position 9, 12, 234, 239, 256, fluid management 222, 225 maternal collapse 126 257 intracranial 11 neonate 241–242 legal implications. See medico-legal life support 13 twin delivery 93–94 major trauma 234, 235–236, 237 implications maternal collapse 10, 128 hypoxic ischaemic encephalopathy life support 12–13, 177 (HIE) 267 uterine inversion 121 ligation, blood vessels 38 see also massive obstetric hysterectomy 39, 123, 253 haemorrhage linea nigra 3 HAEMOSTASIS mnemonic 33, 35, imaging lithium 178, 207 36–39 abdominal pain 154 major trauma 237 lithotomy position 135 hallucinations 171 see also radiology and see specific liver 4, 118, 205 Haultain’s operation 123 modalities locked twins 96 heart 1–2.Seealsocardiac disease immune transfusion reactions 227–228 Løvset’s manoeuvre 63, 64

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low-resource settings 73 fluid management 221–222 miscarriage 154 blood transfusion 232 general anaesthesia 214–215 Modified Early Obstetric Warning breathlessness 153 instrumental delivery 98–99, 104 System (MEOWS) 44, 113, 131, breech delivery 66 major trauma 233 187 caesarean section 113–114 massive obstetric haemorrhage convulsions/epilepsy 195–197 33–34 MOH (massive obstetric haemorrhage) deep vein thrombosis 22–23 morbidly adherent placenta 250 33–34, 35, 39, 252, 257 diabetic ketoacidosis 190 musculoskeletal problems 198, molar pregnancies 206 fire drills, labour ward 262 200 fluid management 224–225 myxoedema coma 207 mood 173.Seealsopsychiatric general anaesthesia 219 perineal trauma 138–139 emergencies instrumental delivery 105 preeclampsia/eclampsia 24–25 morbidly adherent placenta 250–255 major trauma 238, 239 psychiatric emergencies 170 Morganella morganii 41 maternal collapse 13–14 retained placenta 132–133 musculoskeletal problems 200, sepsis/septic shock 42 mortality, neonatal 246 201–202 shoulder dystocia 88 moulding 100 perineal trauma 143 simulation training 265 preeclampsia/eclampsia 31 thyroid storm 204 MRI scans 200, 212 psychiatric emergencies 174 twins 93–94 multidisciplinary teams 265, 270 resuscitation, neonatal 247–248 uterine rupture 52 musculoskeletal problems 155, retained placenta 136–137 maternity dashboards 273 198–199, 201, 202, 203 risk management 274 shoulder dystocia 92 Mauriceau–Smellie–Veit manoeuvre myocardial infarction 10 twin delivery 97 (MSV) 64 myopia, high 168–169 uterine rupture 55–56 McRobert’s manoeuvre 89 myxoedema coma 207–208 lung function 9–10 meconium aspiration 246 lung injury, transfusion related medication. See drugs N acetyl cysteine 177–180 (TRALI) 228 Medicines and Healthcare Products NALS (Neonatal Advanced Life lymphocytic hypophysitis 212 Regulatory Agency (MHRA) Support) course 241 231 NAPQI MAC (minimum alveolar (N-acetyl-p-benzoquinonimine) concentration) 217 medico-legal implications caesarean section 115, 258 177–180 magnesium sulphate 26, 28, 31 deep vein thrombosis 16 National Patient Safety Agency major trauma 233–238, 239, 257 instrumental delivery 99 (NPSA) 272 maternal collapse 126 neonatal physiology 241–242 malignancy hyperthermia 216 retained placenta 133 Mallampati scores 214 shoulder dystocia 88 neurological causes, maternal collapse 128 MAOI (monoamine oxidase simulation training 265 inhibitors) 178 uterine rupture 52 neurological disability 236 massage, uterine 37, 116 melasma 3 Newborn Life Support (NLS) course 241 massive obstetric haemorrhage 33–34, meningiomas 168 35, 39, 252, 257 mental state examination 172 NHS Litigation Authority (NHSLA) 272 maternal collapse 9–14 MEOWS (Modified Early Obstetric amniotic fluid embolism 49 Warning System) 44, 113, 131, NICE (National Institute for Health fire drills, labour ward 260 187 and Clinical Excellence) guidelines 81, 272 postpartum 126–128, 131 metabolic disorders 11 nitroglycerin 133–134 maternal implications methotrexate 252 amniotic fluid embolism 48 non-haemolytic immune reactions blood transfusion 228, 230 metoclopramide 110 227–228 breathlessness 150 MHRA (Medicines and Healthcare breech delivery 61 non-proliferative diabetic retinopathy Products Regulatory Agency) 167 caesarean section 108–109, 115 231 convulsions/epilepsy 192 normalisation, psychiatric 173 midline incisions 110 deep vein thrombosis 15 NPSA (National Patient Safety diabetic ketoacidosis 185 minimum alveolar concentration Agency) 272 drug overdose 176 (MAC) 217

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NSAIDs (non-steroidal physiological anaemia 1, 7 caesarean section, peri/postmortem anti-inflammatories) 178 physiology, newborn infant 241–242 257 case study 225 OASIS (obstetric and sphincter pigmentation, skin 3 fluid management 222, 224 injuries) 138, 140–141.Seealso Pinard manoeuvre 63 maternal collapse 11, 128 perineal trauma twin delivery 93–94 Piper forceps 65, 101 obesity 215 visual problems 164–166 Pipingas technique 134 Objective Structured Assessment of pregnancy1–4,5,6,8 Technical Skills (OSATS) 105 pituitary adenomas 168 management of subsequent 141–142 occult umbilical cord prolapse 68 pituitary apoplexy 211–212 preterm infants 246 opioids 178, 215 pituitary gland 3, 211–213 proactive risk management 271–272 optic atrophy 168 placenta prolactin 212 abruption 35–36, 156, 236 optic neuropathy 165 proliferative diabetic retinopathy delivery 112, 120 167–168 outcomes, simulation training 267 morbidly adherent 250–255 praevia 36 PROM (pre-labour rupture of ovarian cysts 155 retained 132–137 membranes) 69 ovarian hyperstimulation syndrome plasma, blood 1, 7 PROMPT programme, simulation (OHSS) 155–156 training 266 plasma cholinesterase deficiency 215 ovarian stimulation, twins propranolol 206–207, 211 platelets 1, 4 overt umbilical cord prolapse 68 propylthiouracil 206 PMCD (perimortem caesarean oxytocin 96 delivery) 10, 13, 112–113, prospective analysis, risk management breech delivery 62 256–258 273 drug reactions 231 infusion 37–38 pneumonia 150, 151 prostaglandins 37–38 instrumental delivery 101 pneumothorax 12 proteinuria 26 retained placenta 133 poisoning, peri/postmortem CS 257 PROWESS (Recombinant Human Activated Protein C Worldwide paired cord blood samples 104 Polyglactin 140 Evaluation in Severe Sepsis) trial palmar erythema 4 polyhydramnios, acute 156–157 46 palpitations 145–149 posterior ventouse cups 103 psychiatric emergencies 170–174 pancreatitis 159 postmortem caesarean delivery psychosis 170, 173 paracetamol overdose 177–180 (PMCD) 10, 13, 112–113, ptosis 163 256–258 Patrick’s test 198 PTP (post-transfusion purpurea) postpartum haemorrhage (PPH) 33 227–228 penetrating trauma 233, 234 HAEMOSTASIS mnemonic 36–39 peptic ulcer disease 159 instrumental vaginal delivery puerperal uterine inversion 120–124, 105 128 percreta, placenta 250, 252 perineal trauma 142 pulmonary embolism 19–20, 150.See perimortem caesarean delivery retained placenta 132–133 also deep vein thrombosis/ (PMCD) 10, 13, 112–113, risk management 270 venous thromboembolism 256–258 twin delivery 93–94, 97 pulmonary oedema 222, 223, 224 perineal trauma 138–143.Seealso see also massive obstetric breech delivery haemorrhage pulse oximetry 243 perineum 90 postpartum maternal collapse pyrexia 152 126–128, 131 personal protective equipment (PPE) radiology 39, 183–184.Seealso 110 post-transfusion purpurea (PTP) 227–228 imaging Pfannenstiel incision 110 potassium chloride 187 ranitidine 110 phaeochromocytoma crisis 210–211 pre-labour rupture of membranes reactive risk management 272 Phalen’s test 198 (PROM) 69 rectus abdominis 158 phenoxybenzamine 210 prednisolone 185, 206–207 red blood cell (RBC) volume 1, 4 photopsia 165 preeclampsia 24–31 renal disease 25

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renalsystem2–3,4,5,6,224 twin delivery 93–94 morbidly adherent placenta 252–254 report writing, simulation training 266 Sheehan’s syndrome 211 OASIS (obstetric and sphincter injuries) 140–141 respiratory distress syndrome (RDS) shock, acute puerperal uterine phaeochromocytoma crisis 211 43, 109 inversion 120, 121–122.Seealso sepsis/septic shock 46 respiratory system 2, 5, 6.Seealso sepsis/septic shock uterine rupture 53–55 breathing shock index 35 Surviving Sepsis Campaign 43, 44–46, restraint, psychiatric emergencies 174 shoulder dystocia 88–92 157 resuscitation fire drills, labour ward 260, 262 symphysiotomy 92 amniotic fluid embolism 49 instrumental vaginal delivery 105 risk management 270 symphysis pubis diasthesis (SPD) 158, caesarean section 256–258 199, 200–202 diabetic ketoacidosis 186 simulation training 267 maternal collapse 9–10, 126, sickle cell crisis 159 synclitism 99 127–131 simulation training 264–267 syncope 145, 148, 151, 192 neonatal 241–248 syntocinon 109, 218 uterine rupture 53 SIRS (systemic inflammatory response syndrome) 41, 157 Syntometrine 37, 96 retained placenta 132–137 skin 3–4, 6, 7 systemic inflammatory response retinal detachment 165–166 SOS Bakri balloon catheter 122 syndrome (SIRS) 41, 157 retinopathy 165, 166, 167–168 SPD (symphysis pubis diasthesis) 158, systems analysis, risk management Reverse Wood’s screw manoeuvre 90 199, 200–202 272–273 rhesus typing 237 speech assessment, psychiatric tachycardia 43, 145, 148.Seealso risk management 269–274 emergencies 172 cardiotocography; palpitations deep vein thrombosis/pulmonary spider gravidum/naevi 3 embolism 17, 23 tachypnoea 43 drug overdose 177, 180 spleen, ruptured 118 TACO (transfusion associated preeclampsia/eclampsia 25 SSRI (selective serotonin-reuptake circulatory overload) 228 psychiatric emergencies 171, 173 inhibitors) overdose 178 tamponade 12, 38 simulation training 265 ST acronym, maternal collapse 12 teaching skills 265 risk registers 273 stab wounds 234 teamwork, simulation training 266 road traffic accidents 233–238, 239, 257 standards, Clinical Negligence Scheme tear film changes 163–164 root cause analysis (RCA) 272–273 for Trusts 272.Seealsoguidelines temperature Royal College of Anaesthetists 215 Staphylococcus aureus 41 maternal 11, 43, 205, 228 Royal College of Obstetricians and starvation, for general anaesthesia 217 neonatal 243 Gynaecologists (RCOG) 272 see also myxoedema coma station, fetal head 99, 112, 115, 116 rudimentary horn rupture 156 Templeton review 265 status epilepticus 194.Seealso rule of 30 35 convulsions/epilepsy tension, pneumothorax 12 teratogenicity 176, 192, 237 SAFE acronym, domestic violence 238 sterilisation, during caesarean section 113 terbutaline 122–123 safety. See risk management steroids 46 Term Breech Trial 61 seatbelt use 238 stethoscopes 242 tetanus immunisation 237 seizures 4, 28, 191–195, 196, 197 Streptococcus pneumoniae 41 theophylline overdose 178 self-harm 170 suicide 170, 172, 173.Seealsodrug thermoregulatory dysfunction. See Sengstaken–Blakemore oesophageal overdose temperature catheter (SBOC) 38 sulphonyl-ureas overdose 180 3 Es (examination, explanation, sepsis/septic shock 11, 41–47 escalation) 118 abdominal pain 157 surgery acute puerperal uterine inversion massive obstetric haemorrhage 39 caesarean section, peri/postmortem retained placenta 136 257 123 caesarean section 110–112 shoulder dystocia 91–92 fluid management 225 simulation training 266 maternal collapse, postpartum 126, episiotomy repair 140 128 hypopituitarism 213 thrombin 118

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thromboembolism. See deep vein transfusion associated circulatory umbilical cord prolapse 68–76 thrombosis/venous overload (TACO) 228 fire drills, labour ward 260 thromboembolism transfusion, blood simulation training 267 thromboprophylaxis 110, 188, major trauma 235–236 twin delivery 93–94 237 postpartum haemorrhage 37 urinary tract infections 158 thrombosis, and breathlessness reactions 227–232 urine retention 155 151 transfusion related acute lung injury urticaria 227–228 (TRALI) 228 thrombotic thrombocytopenic purpua uterus (TTP) 166 transient tachypnoea of the newborn incision, CS 111 thyroid 3, 4, 7 (TTN) 109 inversion 120–124, 128 endocrine emergencies 204–207.See trauma, major 233–238, 239, 257 manual replacement 122 also myxoedema coma Trendelenburg position 70 massage 37 eye disease 168 rupture 52–57, 93–94 trial of instrumental delivery 105 tilt-table testing 147 scar dehiscence 157 tricyclic antidepressants, overdose tamponade 38 Tinel’s test 198 181 torsion 157 tocolysis trigger lists, risk management 272 acute puerperal uterine inversion vascular lacunae 250 122–123 triple P procedure 253–254 vena cava syndrome 174 caesarean section 116 TTN(transienttachypnoeaofthe venous thromboembolism. See deep fluid management 222 newborn) 109 retained placenta 133 vein thrombosis/VTE TTP (thrombotic thrombocytopenic ventilation. See breathing tone, neonatal 242 purpura) 166 too little too late 39 ventouse delivery 103–104, 122.See tumours, intracerebral 168 also instrumental vaginal delivery torsion, uterine 157 twin delivery 93–97, 270 Vicryl Rapide 140 traction, umbilical cord 120, 134, twin-to-twin transfusion syndrome visual problems 163–169, 213 135 (TTTS) 93, 94 training programmes websites, Objective Structured instrumental vaginal delivery UK Newborn Life Support (NLS) Assessment of Technical Skills 105–106 course 241 105 resuscitation, neonatal 241 UK Resuscitation Council guidelines WHO (World Health Organization) umbilical cord prolapse 73–76 236 uterine rupture 56–57 guidelines 247–248 ultrasound scanning 25, 94, 237, Wood’s screw manoeuvre 90 TRALI (transfusion related lung 250 injury) 228 umbilical cord X-rays 223, 237 tranquillisation, psychiatric clamping 243 emergencies 174 traction 120, 134, 135 Zavanelli manoeuvre 91, 92

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