PPH

Question 1

how much fluid can you give whilst awaiting blood products

Answer 1

Up to 2 litres crystalloid and 1.5 litres colloid

Question 2

when would you give FFP?

Answer 2

If ongoing haemorrhage and no haemostatic tests results available after 4 units of blood
or
earlier if significant coagulopathy suspected (or proven)

Question 3

How much FFP should you give (if needed)?

Answer 3

4 units FFP (after 4 units blood)
or
12 - 15 ml/kg if there’s prolonged APTT or PT
or
>15 ml/kg if APTT are >1.5x normal

Question 4

what’s the trigger level of platelets that says you need to give them a pool of platelets

Answer 4

75

Question 5

what’s the trigger level of fibrinogen?
what do you give if fibrinogen is this low?
how much do you give?

Answer 5

2 g/L is the trigger level
give cryoprecipitate
2 pools

Question 6

how much miso do you give in PPH, and how do you give it?

Answer 6

800 mcg
sublingually!
or rectally

Question 7

maximum frequency and number of doses of IM carboprost

Answer 7

15 minutes
8 doses total
250mcg each

Question 8

what is the dose of ergo?

Answer 8

500 micrograms

Question 9

timing of standard uterotonics (i.e. to prevent, not treat, PPH)

Answer 9

should be given immediately after the birth of the baby
and before the cord is clamped and cut

Question 10

For each of the following, say if they are synthetic or naturally occurring, and which prostaglandin they are.
Misoprostal
Dinoprostone
Dinoprost
Carboprost

Answer 10

Misoprostal (Synthetic Prostaglandin E1 analogue) half-life 40 minutes
Dinoprostone (Naturally occurring Prostaglandin E2)
Dinoprost (Naturally occurring Prostaglandin F2 Alpha)
Carboprost (Synthetic Prostaglandin F2 Alpha analogue)