Launching Obstetric ALERT Dr Helen Peet Consultant in Critical Care and Anaesthesia Portsmouth Hospitals NHS Trust 1

Obstetric Critical Care Maternal mortality continues to fall For every death there are at least 10 cases of significant morbidity Influenza 2

A Personal Perspective 3

Just a few slides…. And a few more … a bit of consulting … some bribery … a new manual …and a new symbol 4

Aims of the Obstetric ALERT TM Course Identification of the at risk obstetric patient Identification of the at risk obstetric patient Appropriate management of acutely ill women and prompt escalation of care Appropriate management of acutely ill women and prompt escalation of care Improved team working and communication Improved team working and communication Avoidance of preventable maternal harm and death Avoidance of preventable maternal harm and death Prioritisation of maternal wellbeing over fetal wellbeing Prioritisation of maternal wellbeing over fetal wellbeing

Learning Objectives Understand the systematic assessment Understand the systematic assessment Recognise when to call for help Recognise when to call for help Understand the simple interventions and monitoring required Understand the simple interventions and monitoring required Understand the importance of clear communication and documentation Understand the importance of clear communication and documentation

Course Structure Sepsis features highly ALERT system of assessment Recognition of different audience More emphasis on group work and workshops Recognition of 2 patient problem but emphasis on maternal welfare Sepsis features highly 7

Course Contents Same system of assessment Incorporation of “F” into assessment Continues to stress recognition of life threatening emergencies General topics adapted for obstetrics Obstetric specific topics discussed 8

The ALERT TM System of Assessment

Immediate Assessment AirwayBreathingCirculationDisabilityExposureFetus

Scenarios Eclampsia Hypoglycaemia Sepsis MOH PE Anaphylaxis 11

Faculty Demonstration 12

Questions 13

Food for thought The reviews clearly illustrate that timely recognition of risk, the severity of the condition, accurate diagnosis, involvement of the correct senior staff from multiple disciplines, escalation and prompt treatment and action can make the difference between life and death. Knight M, Kenyon S, Brocklehurst P, Neilson J, Shakespeare J, Kurinczuk JJ (Eds.) on behalf of MBRRACE-UK. Saving Lives, Improving Mothers’ Care - Lessons learned to inform future maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009–12. Oxford: National Perinatal Epidemiology Unit, University of Oxford