Estimated Blood Loss vs Quantification of Blood Loss: an objective method that provides accountability, beginning with your practice.
Synopsis
Women die from obstetric hemorrhage because effective interventions are not initiated early enough. Several factors influence PPH rates, such as how blood loss is measured at delivery. Participants will learn how to objectively estimate blood loss.
Background
The Joint Commission in 2010 reported that the leading cause of maternal morbidity and mortality is failure to recognize excessive blood loss during childbirth. However there is no single definition of postpartum hemorrhage. Estimates of blood loss (EBL) are imprecise, inaccurate and often overestimated at low volumes and underestimating at high volumes. The lack of accurate assessment can leads to delay in diagnosis and treatment. It has been shown that limited visual instruction significantly improves accuracy of estimation however this is subjective to the provider(s) experience, knowledge, frame of reference and group dynamic.
Purpose
To alleviate the subjectivity in blood loss with QBL, an objective method used to evaluate excessive bleeding which is significantly more accurate than EBL.
Interventions/ format
Conducted one-to-one workshop training with multiple disciple at different levels (obstetricians, doctors, residents, midwives, nurses, anesthesiologists, hematologists/blood bank, laboratory medicine Scrub Teck, Ob Teck, students…).
1) Workshop is open to all who would like to learn about blood loss in PPH
2) Interactive case scenario
3) Introduction to the scope of the problem
4) Interactive Visual Activity for EBL
5) Group Activity
6) Hands individual assessment of QBL
7) Group assessment
8) Debriefing-comparing the two method of practice
9) Wrap up
Conclusion/ outcomes for participants.
The management of PPH is multifaceted and requires a well-coordinated, multidisciplinary approach often by several teams within the hospital and in the community. In this workshop we begin the process with participant, helping them to have a better understanding of how subjectivity, group dynamics and self-awareness can impact patient outcome providing a new or reinforce their approach with the use of QBL. Which reduces the likelihood that clinicians will underestimate the volume of blood lost and delay early recognition and treatment.