Training health workers to prevent and manage post-partum haemorrhage (PPH) |
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| Institution: | 1. Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX (Dr Detlefs);2. Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY (Dr Goffman);3. University of the Incarnate Word School of Osteopathic Medicine, San Antonio, TX (Ms Buttle);4. Baylor University, Waco, TX (Mr Crump);5. Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY (Dr Thornburg);6. Banner-University Medical Center Phoenix, The University of Arizona College of Medicine-Phoenix, Phoenix, AZ (Dr Foley);7. Department of Obstetrics and Gynecology, Christus Health, Baylor College of Medicine, San Antonio, TX (Dr Deering);1. Academic Department of Obstetrics and Gynaecology, Imperial College London, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK;2. Adult Congenital Heart Centre, The National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK |
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| Abstract: | Post-partum haemorrhage (PPH) is the second greatest direct cause of maternal death in the United Kingdom, and rates of PPH continue to increase despite advances in clinical care. Training workers to manage PPH involves improvement of technical and non-technical skills in the context of a multidisciplinary team (MDT). Management of PPH should begin in the antenatal period, with identification of high-risk women and referral for multispecialty input. Training for the acute management of PPH should involve all members of the labour ward team and beyond, including haematology and non-clinical staff. Simulation-based training, didactic teaching and hybrid obstetric emergency courses are current options for training workers. Non-technical skills should also be taught, including specific training on communication, leadership, situational awareness and team-working skills. Improving management of obstetric emergencies requires thorough antenatal and intra-partum risk assessment, optimising knowledge and non-technical skills of individual members of the team, improving collaboration of the MDT, better simulation training and adjusting local infrastructure. |
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| Keywords: | Post-partum haemorrhage Obstetric anaesthesia Obstetric emergencies Multi-professional training Simulation training CRM training |
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