Stepwise resuscitation and control of postpartum hemorrhage (4 Ts).
Indications
- • Blood loss > 500 mL vaginal / > 1000 mL LSCS
Equipment
- • Two large-bore IVs
- • Cross-matched blood
- • Oxytocin, ergometrine, carboprost, misoprostol
- • Bakri balloon
- • Surgical kit
Positioning
- • As appropriate for the procedure and patient comfort.
Consent
- • Explain indication, benefits, alternatives
- • Explain risks & complications
- • Obtain written/verbal consent as per SOP
- • Document consent
Universal precautions
- • Hand hygiene
- • PPE — gloves, mask, eye protection
- • Aseptic technique
- • Sharps safety
- • Verify patient identity & site
Step-by-step (0/9)
Tap to complete
Team activation.
Immediate complications
- ⚠ Shock
- ⚠ DIC
- ⚠ Cardiac arrest
Delayed complications
- • Sheehan's syndrome
- • Fistula
- • Death
Recognition
- • Ongoing bleeding
- • Hypotension
Initial management
- • Escalate quickly
Prevention
- • Active management of 3rd stage
Post-procedure observation
- • Vitals q15min × 1h then hourly
Monitoring
- • Site inspection
- • Symptom review
Documentation
- • Procedure note
- • Consent
- • Findings
Patient instructions
- • Report pain, bleeding, fever, worsening symptoms
Drugs used in this procedure
Educational bedside guide. Perform only under supervision until competent. Follow local SOPs and consent policy.
