Complete Solutions
how much blood loss occurs in first stage uterine rupture? Right Ans -
vaginal >500 cc
cesarean >1000 cc
normal VS, Labs
what steps should be taken for stage 1 uterine rupture? Right Ans - 1.
record VS, O2 sats every 5 minutes
2. record total EBL
3. foley catheter
4. IV access (16G)
5. increase IV fluids (crystalloid)
6. fundal massage
7. treat etiology (see card)
8. 2 units PRBCs
what are the 4 T's of uterine bleeding? Right Ans - 1. Tone (atonic uterus)
70%
2. trauma (lacs, hematomas, inversion) 20%
3. tissue (retained, invasive) 10%
4. Thrombin (coagulopathies) 1%
what meds and in what order are given during stage 1 uterine bleeding?
Right Ans - 1. pitocin 40-80 IU/liter
2. 0.2 mg IM methergine
3. 250 mcg hemabate (q15 minutes, max 8 doses)
4. misoprostol 800-1000 mcgs rectally
what characterizes a second stage uterine bleed? Right Ans - ~1500 cc of
EBL or patients requiring 2+ uterotonics
what steps should be take in stage 2 uterine bleeding? Right Ans - 1. IV
access 2
2. stat labs, coags, fibrinogen
3. warming blanket
4. if uterine atony, place balloon or sugery