Obsgynaecritcare

"You are called urgently into one of the birth suite rooms. A woman has just given birth, there is blood everywhere, she is moaning & breathing (barely). She is a ghastly pale / mottled colour and you can't feel a peripheral pulse..... it is a sunday afternoon, you work in a smaller hospital and the theatre team aren't on site......." Being faced with a shocked / peri-arrest obstetric patient who is literally exsanguinating in front of you is one of those nightmare situations that  those of us who work in obstetrics dread being faced with. The sudden uterine rupture, the unexpected placenta accreta, or an amniotic fluid embolism with ensuing severe coagulopathy all spring to mind. This is also not an uncommon event in theatre in women having surgery for placenta accreta/percreta or ruptured ectopics - where we are usually prepared for massive haemorrhage but despite this where we can suddenly find ourselves in a situation where the rate of blood loss is so catastrophic that we have lost control of the patien