Retrospective Analysis of IV Flow Capacity in Obstetric Patients at Risk for Postpartum Hemorrhage [30L]

Jennie Olympio; Bo Cai; Shannon Theobald; Anastasia Castillo; David Schrift; Lauren Castleberry

doi:10.1097/01.aog.0000533569.44928.fb

Retrospective Analysis of IV Flow Capacity in Obstetric Patients at Risk for Postpartum Hemorrhage [30L]

Jennie Olympio
, Bo Cai
, Shannon Theobald
, Anastasia Castillo
, David Schrift
, Lauren Castleberry

Research output: Contribution to journal › Article › peer-review

Abstract

INTRODUCTION: Postpartum hemorrhage (PPH) is one of the leading causes of preventable pregnancy-related mortality. However, the risk of PPH can be estimated prior to its occurrence, which allows clinicians to take the necessary precautions to manage high-risk patients. This includes establishing two, 18-gauge (large-bore) intravenous (IV) catheters, an imperative first step in managing hemorrhaging patients. This retrospective study aims to assess how often obstetrical patients at high-risk for PPH received appropriate IV access, defined as two 18-gauge or larger IVs. METHODS: A retrospective analysis of 922 obstetrical patients admitted to our institution over a 6-month period was performed. A patient's risk for PPH was determined on admission. Patients were stratified into low, medium and high-risk groups. The number and size of IV catheters inserted upon admission were reviewed. RESULTS: Of the 922 patients analyzed, 10% (93) were deemed high-risk for PPH. Of those patients, 93.5% (87) received a single IV catheter on admission, of which 75% were 20-gauge or smaller IVs. Only 1% (1) of the high-risk patients received appropriate IV access (two 18-gauge or larger IVs). CONCLUSION: Only 1% of patients at high-risk for PPH received appropriate IV access. Our data represents a single-center experience and should be confirmed. However, these results are concerning and suggest PPH patients may experience under-resuscitation and/or a delay in resuscitation due to inadequate IV access. Based on this data, the authors plan to revise the current Postpartum Hemorrhage Protocol and implement a new policy to ensure appropriate IV access is obtained in patients at high-risk for PPH.

Original language	English
Journal	Obstetrics and Gynecology
DOIs	https://doi.org/10.1097/01.aog.0000533569.44928.fb
State	Published - May 2018

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@article{d4d9c0688c6242c998eba5dd7bbb0d05,

title = "Retrospective Analysis of IV Flow Capacity in Obstetric Patients at Risk for Postpartum Hemorrhage [30L]",

abstract = " INTRODUCTION: Postpartum hemorrhage (PPH) is one of the leading causes of preventable pregnancy-related mortality. However, the risk of PPH can be estimated prior to its occurrence, which allows clinicians to take the necessary precautions to manage high-risk patients. This includes establishing two, 18-gauge (large-bore) intravenous (IV) catheters, an imperative first step in managing hemorrhaging patients. This retrospective study aims to assess how often obstetrical patients at high-risk for PPH received appropriate IV access, defined as two 18-gauge or larger IVs. METHODS: A retrospective analysis of 922 obstetrical patients admitted to our institution over a 6-month period was performed. A patient's risk for PPH was determined on admission. Patients were stratified into low, medium and high-risk groups. The number and size of IV catheters inserted upon admission were reviewed. RESULTS: Of the 922 patients analyzed, 10\% (93) were deemed high-risk for PPH. Of those patients, 93.5\% (87) received a single IV catheter on admission, of which 75\% were 20-gauge or smaller IVs. Only 1\% (1) of the high-risk patients received appropriate IV access (two 18-gauge or larger IVs). CONCLUSION: Only 1\% of patients at high-risk for PPH received appropriate IV access. Our data represents a single-center experience and should be confirmed. However, these results are concerning and suggest PPH patients may experience under-resuscitation and/or a delay in resuscitation due to inadequate IV access. Based on this data, the authors plan to revise the current Postpartum Hemorrhage Protocol and implement a new policy to ensure appropriate IV access is obtained in patients at high-risk for PPH. ",

author = "Jennie Olympio and Bo Cai and Shannon Theobald and Anastasia Castillo and David Schrift and Lauren Castleberry",

year = "2018",

month = may,

doi = "10.1097/01.aog.0000533569.44928.fb",

language = "English",

journal = "Obstetrics and Gynecology",

issn = "0029-7844",

publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - Retrospective Analysis of IV Flow Capacity in Obstetric Patients at Risk for Postpartum Hemorrhage [30L]

AU - Olympio, Jennie

AU - Cai, Bo

AU - Theobald, Shannon

AU - Castillo, Anastasia

AU - Schrift, David

AU - Castleberry, Lauren

PY - 2018/5

Y1 - 2018/5

N2 - INTRODUCTION: Postpartum hemorrhage (PPH) is one of the leading causes of preventable pregnancy-related mortality. However, the risk of PPH can be estimated prior to its occurrence, which allows clinicians to take the necessary precautions to manage high-risk patients. This includes establishing two, 18-gauge (large-bore) intravenous (IV) catheters, an imperative first step in managing hemorrhaging patients. This retrospective study aims to assess how often obstetrical patients at high-risk for PPH received appropriate IV access, defined as two 18-gauge or larger IVs. METHODS: A retrospective analysis of 922 obstetrical patients admitted to our institution over a 6-month period was performed. A patient's risk for PPH was determined on admission. Patients were stratified into low, medium and high-risk groups. The number and size of IV catheters inserted upon admission were reviewed. RESULTS: Of the 922 patients analyzed, 10% (93) were deemed high-risk for PPH. Of those patients, 93.5% (87) received a single IV catheter on admission, of which 75% were 20-gauge or smaller IVs. Only 1% (1) of the high-risk patients received appropriate IV access (two 18-gauge or larger IVs). CONCLUSION: Only 1% of patients at high-risk for PPH received appropriate IV access. Our data represents a single-center experience and should be confirmed. However, these results are concerning and suggest PPH patients may experience under-resuscitation and/or a delay in resuscitation due to inadequate IV access. Based on this data, the authors plan to revise the current Postpartum Hemorrhage Protocol and implement a new policy to ensure appropriate IV access is obtained in patients at high-risk for PPH.

AB - INTRODUCTION: Postpartum hemorrhage (PPH) is one of the leading causes of preventable pregnancy-related mortality. However, the risk of PPH can be estimated prior to its occurrence, which allows clinicians to take the necessary precautions to manage high-risk patients. This includes establishing two, 18-gauge (large-bore) intravenous (IV) catheters, an imperative first step in managing hemorrhaging patients. This retrospective study aims to assess how often obstetrical patients at high-risk for PPH received appropriate IV access, defined as two 18-gauge or larger IVs. METHODS: A retrospective analysis of 922 obstetrical patients admitted to our institution over a 6-month period was performed. A patient's risk for PPH was determined on admission. Patients were stratified into low, medium and high-risk groups. The number and size of IV catheters inserted upon admission were reviewed. RESULTS: Of the 922 patients analyzed, 10% (93) were deemed high-risk for PPH. Of those patients, 93.5% (87) received a single IV catheter on admission, of which 75% were 20-gauge or smaller IVs. Only 1% (1) of the high-risk patients received appropriate IV access (two 18-gauge or larger IVs). CONCLUSION: Only 1% of patients at high-risk for PPH received appropriate IV access. Our data represents a single-center experience and should be confirmed. However, these results are concerning and suggest PPH patients may experience under-resuscitation and/or a delay in resuscitation due to inadequate IV access. Based on this data, the authors plan to revise the current Postpartum Hemorrhage Protocol and implement a new policy to ensure appropriate IV access is obtained in patients at high-risk for PPH.

UR - http://dx.doi.org/10.1097/01.aog.0000533569.44928.fb

U2 - 10.1097/01.aog.0000533569.44928.fb

DO - 10.1097/01.aog.0000533569.44928.fb

M3 - Article

SN - 0029-7844

JO - Obstetrics and Gynecology

JF - Obstetrics and Gynecology

ER -

Retrospective Analysis of IV Flow Capacity in Obstetric Patients at Risk for Postpartum Hemorrhage [30L]

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