Topic: Post-partum Hemorrhage Simman
Subject: Medicine

Door Tablet Information

OPENING SCENARIO

FY2 in an obstetrics department where Margaret Reese a 41-year-old female, G5P5, has just delivered a new baby. This is her fifth delivery. 1 hour after delivery she noticed significant vaginal bleeding. The nurse has asked you to review the patient. Please assess the patient and hand over to crash team.


PATIENT INFORMATION

You are the nurse who has been taking care of Margaret Reese, a 41-year-old female, G5P5. You are going to hand over an observation chart on a paper as soon as doctors come in. The observations show a hypotensive, tachycardic patient. You can inform the doctors that the patient started bleeding and feeling dizzy about 15 minutes ago. She had a delivery about 1 hour ago. The patient is initially mumbling and unable to talk or give history until the doctors finish their ABCDE protocol or at the very least until the BP changes from hypovolemic shock to normal BP. There was no laceration or tear. The birth was by vaginal delivery. The child was 4.5 kg. The delivery lasted 18 hours.

Setup: The candidates are expected to expose the patient and do an examination of the abdomen and the pelvis. The vaginal area is full of simulated blood.

Another healthcare professional will walk in when the patient has been stabilized [at 6 minutes] and the managing FY2 doctor is expected to hand over the patient using the ISBAR protocol.

The examiner is the registrar