June 2005 · Vol. 17, No. 6Catastrophic intraoperative hemorrhage: 5-step action plan
If this emergency cannot be averted with careful preoperative assessment, rely on a reasoned plan, basic tools, a few new tools, and tried-and-true techniques.
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Fast Track
If the bleeding source is unknown, apply pressure on the aorta using a hand, weighted speculum, or aortic compressor
You have to ask. Alternative remedies can impair coagulation—and over 60% of people taking them do not tell their doctor
Perform primary volume expansion before replacing blood or blood components
Presacral venous bleeding can be controlled by inserting stainless steel thumbtacks, with direct pressure from the surgeon’shand, directly into the sacrum
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Donald
G.
Gallup,
MDProfessor and Chair
Department of Obstetrics
and Gynecology
Mercer University
School of Medicine
Memorial Health University
Medical Center, Savannah, Ga
SALLY’S CASE
Placenta accreta leads to hemorrhage
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