Maximizing Fidelity

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scenario for postpartum hemorrhage
by debra rossie - Thursday, January 6, 2011, 3:04 PM
Does anyone have a scenario for postpartum hemorrhage that I can use next week? It is for student nurse midwives?
Picture of Deborah Johnston
Re: scenario for postpartum hemorrhage
by Deborah Johnston - Wednesday, January 12, 2011, 7:43 PM

I don't have the scenario, but do know how to make good blood  clots!

Mix the artificial blood with thickit thickener and some blue food coloring.  Put on the peripad with a spoon....very realistic.

Deb J

Picture of Nicole Pascher
Re: scenario for postpartum hemorrhage
by Nicole Pascher - Thursday, January 13, 2011, 2:03 PM

We use grape jelly.  It makes great clots!  Takes a minute to clean up, but works well on the manikin and on pads.

Nicole Pascher, MS, RN, CPN


Picture of Crissy Hunter
Re: scenario for postpartum hemorrhage
by Crissy Hunter - Monday, January 17, 2011, 6:59 PM

This is what I just used....I ran the mannequin on the fly. Used actual dough for my fundus. I used cherry pie filling mixed with red&blue food coloring for hemorrhage. If you freeze contents then smash with spoon it looks real.

Doris Bowman is a 33-year-old female, gravida 1, para 1, abortion 0, living 2, with a history of occasional episodes of asthma. She states she has used her inhaler twice during this pregnancy. Her blood type is O positive. It is 2 hours post normal spontaneous vaginal delivery of twins at 37-weeks’ gestation. The twin boys are her first children. The patient experienced onset of Pregnancy-Induced Hypertension (PIH) during labor with blood pressure readings reaching 140/90 and trace urine protein noted. The condition resolved following epidural anesthesia, and there was no further therapy initiated for PIH. Blood pressure was carefully monitored during labor. A urinary catheter was inserted following epidural anesthesia and removed prior to the second stage of labor. Lab values prior to delivery were within normal limits. Following epidural anesthesia at 4cm dilation, the patient experienced hypotonic labor and oxytocin augmentation of labor was instituted. Sixteen hours following spontaneous onset of labor, she progressed to a spontaneous vaginal delivery of twin boys, both cephalic presentations. Twin A (Apgar 8/9) weighed 7 pound 2 ounces, and Twin B (Apgar 7/9) weighed 7 pounds 6 ounces. She had an episiotomy with partial third degree extension that was repaired with 2-0 and 3-0 chromic under epidural anesthesia. No other lacerations indicated on the delivery record. Estimated blood loss following delivery was 500ml. Postpartum recovery period was within normal limits. There were no episodes of unusual bleeding or clots. The patient is currently on the postpartum unit following transfer from the labor and delivery room. Her husband is at her bedside, and their newborns are in the well-baby nursery. She plans on breastfeeding her twins. She desires future fertility.

Past Medical History: Asthma. Denies smoking, drinking, or drug use.

Medications: Docusate sodium 100mg PO BID

PRN Medications: Hydrocodone 7.5mg/325mg PO Q4h PRN pain, Ibuprofen 800mg PO Q8h PRN cramps, Flurazepam 30mg PO QHS PRN insomnia, Albuterol inhaler at bedside, 2 puffs PRN asthma symptoms.

Allergies: No known allergies


1.    Performs basic physical assessment of the postpartum patient.

2.    Identifies signs and symptoms of postpartum hemorrhage.

3.    Determines most likely cause of hemorrhage.

4.    Performs appropriate nursing management interventions for the woman experiencing postpartum hemorrhage.

5.    Administers blood administration according to policy and procedures.

6.    Evaluates effectiveness and revises plan of care as indicated according to patient’s condition and assessment.

7.    Student will develop skills as a team leader, patient advocate, and effective communicator.

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Re: scenario for postpartum hemorrhage
by ali lkan - Saturday, June 23, 2012, 7:15 AM
A young primigravida deliverded alive baby one and half hour ago after delivery of placenta patient start bleeding per vaginum.
what is your differentional diagnosis?
How will you evaluate the patient?