Handbook of Obstetric High Dependency Care E-Book

David Vaughan

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 197

Veröffentlichungsjahr: 2010

Beschreibung

Concise practical guidance to managing an Obstetric High Dependency unit The team and clinical environment is the starting point for the Handbook of Obstetric High Dependency Care. The book discusses the structure and requirements of a unit, both clinically and in terms of equipment, protocols and management aims. The main sections cover the investigation, diagnosis and management of clinical disease resulting from pregnancy and incidental to it.

Leseprobe

Contents

List of abbreviations

List of figures

List of boxes

Preface

Chapter 1: Morbidity and mortality in the parturient

Maternal Mortality and CEMACH

Identification of the high risk parturient

Chapter 2: The maternity high dependency unit

Operational Policy

Admission to the MHDU

Discharge from the MHDU

Transfer to ICU

Personnel

Medical

Midwifery/Nursing

Documentation and record keeping

Protocols and guidelines

Environment and equipment

Clinical governance, audit and risk management

The MHDU patient and ethical challenges

Part I: Emergency care

Chapter 3: Emergency management of the obstetric patient – general principles

Immediate assessment

Full patient assessment

Decisions and planning

Invasive monitoring in the MHDU

Chapter 4: Maternal and neonatal resuscitation

Maternal cardiac arrest

Neonatal resuscitation

Part II: Clinical problems

Chapter 5: Headache

Management

Chapter 6: The collapsed patient

Haemorrhage

Hypoxia

Embolism

Seizure (See Chapter 7 for more detail)

Intracranial event

Metabolic causes

Diabetic crises

Chapter 7: Convulsions

Chapter 8: The breathless patient

Respiratory changes in pregnancy

Differential diagnosis of acute breathlessness – cardiac or respiratory

Pleuritic chest pain

Investigations

Treatment principles

Chapter 9: The wheezy mother

Bronchospasm

Chapter 10: Low oxygen saturation and oxygen therapy

Treatment of hypoxia

Oxygen therapy

Chapter 11: Understanding arterial blood gases

PaO2 – the partial pressure of oxygen in arterial blood

PaCO2 – the partial pressure of carbon dioxide in the blood

pH – the negative log10 of the hydrogen ion concentration

Interpretation of blood gas data

Common disorders of acid–base balance found in the MHDU

Chapter 12: The abnormal chest X-ray

Describe the film

Abnormalities

Chapter 13: Chest pain

Chapter 14: Abnormal heart rate, rhythm or ECG findings

Heart rate

Heart rhythm

Chapter 15: High blood pressure

Pre-existing hypertension

Pregnancy-induced hypertension

Pre-eclampsia

Eclampsia

Management of uncontrolled hypertension

Chapter 16: Low blood pressure

Management of hypotension

Obstetric emergencies

Anaesthetic causes

Drug causes

Central venous access and pressure measurement

Chapter 17: Bleeding and transfusion

Cause and risk factors of obstetric haemorrhage

Management of obstetric haemorrhage

Chapter 18: Rashes and itching

Urticarial disorders

Infections

Other disorders

Chapter 19: Temperature and infection

Hyperthermia or pyrexia

Hypothermia

Sepsis

Chapter 20: Abdominal pain and jaundice

Abdominal pain

Investigations

Management

Vomiting

Jaundice

Chapter 21: Management of pain on the MHDU

Options for management

Chapter 22: Immobility and thromboembolic disease

Prophylaxis

Diagnosing DVT on the MHDU

Pulmonary embolism

Chapter 23: Abnormal urine output and renal function

Oliguria

Diagnosis and investigations

Management of the oliguric patient

Polyuria

Chapter 24: Fluid therapy

Physiology

Crystalloids

Colloids

Chapter 25: Abnormal blood results

Cell abnormalities

Coagulation studies

Electrolyte disorders

Urea and creatinine

Liver function tests

Complement reactive protein

Chapter 26: Anaphylaxis

Recognition and diagnosis

Immediate management

Secondary management

Latex allergy

Chapter 27: Local anaesthetic toxicity

What does the term % mean?

Signs and symptoms of mild toxicity

Signs and symptoms of severe local anaesthetic toxicity

Treatment of severe local anaesthetic toxicity

Selected bibliography

Index

This edition first published 2010, © 2010 by David Vaughan, Neville Robinson, Nuala Lucas, Sabaratnam Arulkumaran

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Library of Congress Cataloging-in-Publication Data

Handbook of obstetric high dependency care / David Vaughan ... [et al.].

p. ; cm.

Includes bibliographical references and index.

ISBN 978-1-4051-7821-1 (pbk.)

1. Pregnancy—Complications—Handbooks, manuals, etc. 2. Obstetrics—Handbooks, manuals, etc. 3. Critical care medicine—Handbooks, manuals, etc. I. Vaughan, David, MBBS.

[DNLM: 1. Pregnancy Complications—therapy. 2. Critical Care—methods. WQ 240 H2365 2010]

RG573.H36 2010

618.2—dc22

2010023981

ISBN: 978-1-4051-7821-1

A catalogue record for this book is available from the British Library.

List of abbreviations

We have endeavoured to expand all abbreviations used in the text, but for ease of reference the more common are listed below.

AAGBIAssociation of Anaesthetists of Great Britain and IrelandABC/ABCDESteps of emergency assessment/resuscitation – airway, breathing, circulation, disability, exposureACEangiotensin-converting enzymeAFatrial fibrillationAFLPacute fatty liver of pregnancyALSadvanced life supportALTalanine transaminaseAPanteroposteriorAPGARquick vital sign scoring system for newborn babiesARFacute renal failureASTaspartate transaminaseATNacute tubular necrosisAVMarteriovenous malformationAVPUCNS function quick assessment tool – Alert, responds to Verbal command, responds to Painful stimulus only, UnresponsiveBD(latin – bis die) twice dailyBMbedside blood sugar assayBMIbody mass index (kg/m2)BPblood pressure (mmHg)CacalciumCCrISPcare of the critically ill surgical patientCMACECentre for Maternal and Child EnquiriesCEMACHConfidential Enquiry into Maternal and Child HealthClchlorine