Yes, we do have implemented the same protocol if pregnant women...with early CVP, arterial and Ultrasound guided fluid resuscitation. Well, what we have additionally found and incorporated in our protocol are as follows:
1. Atonic PPH management under these settings...quite common (Uterotonics...oxytocin can exaggerate hypotension, B-Lynch procedure etc) 2. CUlture placental bed tissue 3. Send immediately neonatal cultures...even if the new born appears normal! 4. Anticipate and prevent hypotension if LSCS is done under regional anaesthesia....they have exaggerated hypotension...in fact, we have diagnosed occult sepsis in retrospect by this exaggerated hypotensive response work-up! 5. Early ScVO2 measurements and lactate clearance are good markers for improvements. Total leukocyte counts are invariably elevated and are unreliable marker during peripartum period. 6. Beware of occult sepsis creeping in parturients with HELLP, AFLP and Thrombotic micro-angiopaties! High vigil is warranted. Best wishes, Sunil *------------* *Dr.Sunil T Pandya* *Medical Director* *Director, Anaesthesia, Pain and Surgical Intensive Care,* *Century Hospital, Hyderabad, India (www.centuryhospital.in <http://www.centuryhospital.in>)* *Organizing Secretary, 8th Annual Conference of AOA India and 1st World Obstetric Anaesthesia **Congress, Hyderabad, 2015.* *Hon. Secretary, Association of Obstetric Anaesthesiologists, India (www.aoaindia.com <http://www.aoaindia.com>)* *Hon. Secretary, Society of Obstetric Medicine, India* *EC member, Obstetric Anaesthesia Society Asia Oceania (OASAO)* *EC member, Academy of Regional Anaesthesia, India (www.aoraindia.com <http://www.aoraindia.com>)* *Programme director, Post doctoral fellowship in Anaesthesia for High risk Obstetrics,* *Head, **Dept. of Anaesthesia, Obstetric Critical care and Pain medicine,* *Fernandez Hospital (Health care for Women and the Newborn), **www.fernandezhospital.com <http://www.fernandezhospital.com>* *Director, Prerna Anaesthesia and Critical Care Services Pvt Ltd (www.prernaanaesthesia.com <http://www.prernaanaesthesia.com>)* *Hyderabad, India.* On Mon, Feb 23, 2015 at 11:02 PM, Riley, Bonnie S. < [email protected]> wrote: > Hello, > > > > Is anyone here using any version of the Surviving Sepsis Campaign in an > obstetrical population? > > > > If so, would you share your experience? I work Risk Management. My > background is both ICU and L&D. I see a need for the protocol, and so does > one of the physicians. We are researching successful strategies for > implementation. > > > > Thanks > > > > Bonnie Riley MSN, RNC, CPHQ > > Performance Improvement Coordinator > > Medical Staff Services M2843 > > Houston Methodist Sugar Land Hospital > > Office: 281-274-7869 > > Fax: 281-274-8028 > > > > Houston Methodist. Leading Medicine. > > Houston Methodist is ranked by *U.S.News & World Report* as one of > America's "Best Hospitals" in 11 specialties and designated as a Magnet > hospital for excellence in nursing. Houston Methodist has also been named > to *FORTUNE® * Magazine's "100 Best Companies to Work For®" list for nine > years in a row. Visit us at houstonmethodist.org. Follow us at > twitter.com/MethodistHosp and facebook.com/HoustonMethodist. > > ***CONFIDENTIALITY NOTICE*** This e-mail is the property of Houston > Methodist and/or its relevant affiliates and may contain restricted and > privileged material for the sole use of the intended recipient(s). Any > review, use, distribution or disclosure by others is strictly prohibited. > If you are not the intended recipient (or authorized to receive for the > recipient), please contact the sender and delete all copies of the message. > Thank you. > > _______________________________________________ > Sepsisgroups mailing list > [email protected] > http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org > >
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