1. ABC and maternal resuscitation

2. Aims Understand primary survey
Airway, Breathing, Circulation, Disability
Assess and treat in this order
To develop and gain competence in the skills needed for maternal Cardio-pulmonary Resuscitation

3. Airway, Breathing Circulation
Why in this order?
Assess and treat each before progressing onto the next

4. Ensure safety Make sure you are not endangering yourself first
Is it safe to approach the patient?

5. First of all…. Is the patient just asleep?
Shake and Shout! (remember they might be deaf!)

6. Call for help
Place patient in tilt, preferably left lateral, 15 to 30 degrees

7. Assessment Airway: LOOK for chest movement
LISTEN for breath sounds, noisy or quiet
FEEL

8. Airway Absent or noisy breath sounds? Open airway
Head tilt and chin lift or jaw thrust

9. Maintain airway
Measure for and insert Guedel’s airway

10. Breathing Is the patient breathing? What is the respiratory rate?
Too fast or two slow, treat with oxygen

11. Circulation Pulse high? Blood Pressure low? Skin cold, hot, sweaty?
Conscious level Aggressive, not alert?
Fetal heart fast, slow, absent?
Urine output reduced?
Colour pale, grey?

12. Circulation Insert two wide bore lines Take bloods Give fluids
Think: Why is there a C problem?
Secondary survey and treat cause

13. If not breathing
Assume cardiac arrest, unless cessation of breathing observed
Commence CPR
/minute
30/2 compressions to
breaths

14. Chest compressions Place heel of hand on lower part of sternum
Place other hand on top and lock fingers
Keep arms straight, lean from shoulders
Depress sternum by 5-6 cms
Rate 120/minute
Very tiring, take turns if possible
30:2 compressions to breaths

15. Reassess Has the cause for the arrest been addressed? When to stop?
Consider peri-mortem caesarean section
Intended to save mother
Bloodless procedure, do there and then, mother is dead anyway if you don’t

16. Any questions?

17. Recap Assess and treat A then B then C TILT patient
Always ensure open airway
Give Oxygen if available
Establish IV lines
Secondary survey