Postpartum Hemorrhage drills

[MKS8806]

Hi Everyone! I have recently taken over the education role for unit (L&D) and our sister units (mother baby and women's surgical). I work for a hospital that is owned by a corporation and we have mandatory education and drills that we are supposed to do at regular intervals. We are required to do postpartum hemorrhage (pph) drills annually. We have a really cool manikin named Noelle, but she belongs to our division, and will be leaving our facility in a few weeks. I have had her for a brief time, but have been unable to run any drills due to our high census at this time. Mother baby has been extremely busy as well. Women's surgical, not quite as busy. When we have overflow on mother baby, sometimes women's surgical will take mom's of NICU babies, and rarely, couplets.

So my question is, how do you guys run drills at your facility? Do you have something, other than a manikin to do scenarios? How do you reinact a boggy uterus and heavy bleeding? I'd like to have something tangible, especially for the women's surgical floor that doesn't routinely take these patients.

Last year I had three written scenarios and questions that went through risk factors, interventions, blood administration, etc.

Thanks in advance!

[TexasCourgette]

At my facility, our educator would make jello and put it in ziplocs for drills is visually estimating bloodloss-- we also had drills in which we would weigh pads that had been soaked (water/food coloring), and had to find and use the reference sheets that are on our PPH carts. We were lucky enough to have a Noelle for the last drills (we had to wheel her to the OR because she had a PPH and then set up all the D&C equipment), but in previous drills we did not. Our educator would drill us through visual blood loss estimates (using the props described above), and would give us scenarios (varying VS, fundal checks, in some scenarios the MD was really responsive, in others not, so you could practice collaborating with other RNs), and then walk us back to the OR so we could set up for D&Cs.

The hardest thing to replicate at my facility is pulling drugs (we had to have a special "practice profile" set up in our pyxis so we could practice pulling anticipatory drugs), labs (same, we always incorporate anticipatory lab supplies), and blood. The "getting blood from the blood bank" part of the drill is the only part that always ends up being written-only, and it's also the part we all feel rusty-est on in a real emergency.

[Mr Midwife, BSN, RN]

I stongly advise looking into the ALSO (Advanced Life Support in Obstetrics) course which was founded by the American Accademy of Family Physicians (AAFP). Management of PPH and MOH is a key component and the theroetical training really is good and they also do advice on how to run high fidelity simulations back in your own clinical areas.