Obstetric Decision-Making and Simulation PDF
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mebooksfree.net Obstetric Decision-Making and Simulation mebooksfree.net Obstetric Decision-Making and Simulation Edited by Kirsty MacLennan Manchester University Hospitals NHS Trust Catherine Robinson Manchester University Hospitals NHS Trust mebooksfree.net University Printing House, Cambridge CB2 8BS, United Kingdom One Liberty Plaza, 20th Floor, New York, NY 10006, USA 477 Williamstown Road, Port Melbourne, VIC 3207, Australia 314–321, 3rd Floor, Plot 3, Splendor Forum, Jasola District Centre, New Delhi – 110025, India 79 Anson Road, #06-04/06, Singapore 079906 Cambridge University Press is part of the University of Cambridge. It furthers the University’s mission by disseminating knowledge in the pursuit of education, learning, and research at the highest international levels of excellence. www.cambridge.org Information on this title: www.cambridge.org/9781108296779 DOI: 10.1017/9781108296793 © Cambridge University Press 2019 This publication is in copyright. Subject to statutory exception and to the provisions of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press. First published 2019 Printed in the United Kingdom by TJ International Ltd. Padstow Cornwall A catalogue record for this publication is available from the British Library. Cambridge University Press has no responsibility for the persistence or accuracy of URLs for external or third-party internet websites referred to in this publication and does not guarantee that any content on such websites is, or will remain, accurate or appropriate. Every effort has been made in preparing this book to provide accurate and up-to-date information that is in accord with accepted standards and practice at the time of publication. Although case histories are drawn from actual cases, every effort has been made to disguise the identities of the individuals involved. Nevertheless, the authors, editors, and publishers can make no warranties that the information contained herein is totally free from error, not least because clinical standards are constantly changing through research and regulation. The authors, editors, and publishers therefore disclaim all liability for direct or consequential damages resulting from the use of material contained in this book. Readers are strongly advised to pay careful attention to information provided by the manufacturer of any drugs or equipment that they plan to use. mebooksfree.net Contents List of Contributors vii Foreword xi Part 1: The Role of Simulation Scenario Section 1: Obstetric 1 Setting the Scene for Simulation-Based 10 Uterine Inversion 57 Education 1 Samantha Bonner Debra Nestel, Kristen Moloney and Simon Hyde 11 Shoulder Dystocia Following Forceps 2 The Where of Simulation Training 11 Delivery for Fetal Bradycardia 66 Al May Samantha Cox and Samiksha Patel 3 Interprofessional In Situ Simulation 16 12 Umbilical Cord Prolapse 73 Jonathan Hurst Michelle MacKintosh 4 Debriefing and the Debrief 22 13 Minimising Decision to Delivery Interval (DDI) Mark Murphy and Annemarie Brown in a Category 1 Caesarean Section – Pre-Theatre Phase 79 5 Fidelity in Obstetric Simulation 29 Cliff Shelton and Sophie Bishop Shane O’Sullivan and Owen O’Sullivan Part 2: The Impact of Human Factors in Scenario Section 2: Maternal Clinical Practice Collapse 6 Introduction to Human Factors and 14 Amniotic Fluid Embolism 87 Ergonomics in Obstetric Simulation 35 Kim Macleod and Yara Mohammed Mark Hellaby 15 Anaphylaxis in Labour 95 7 Situational Awareness, Bias and Decision- Andrew Parkes and Shuayb Elkhalifa Making Styles in Obstetric Simulation 37 16 Acute Pulmonary Embolism in Ian Parkinson and Andrew F. Smith Pregnancy 104 8 Team-Working, Communication and Use of Louise Simcox and David Simcox Communication Aids and Checklists in an Emergency 45 Simon Mercer Scenario Section 3: Hypertensive Disorders of Pregnancy Part 3: Clinical Scenarios 17 Eclampsia 113 9 Introduction to the Scenarios 53 Stephanie Worton, Emma Shawkat Kirsty MacLennan and Jenny Myers v mebooksfree.net Contents 18 HELLP Syndrome with Fetal Compromise Scenario Section 8: Sepsis Requiring an Emergency GA Caesarean Section 121 28 Group A Streptococcal Puerperal Sepsis 219 Emma Shawkat, Stephanie Worton and Laura Coleman and Melissa Whitworth Jenny Myers 29 Pneumonia and Respiratory Failure in a 19 Microangiopathic Haemolytic Anaemia (MAHA) Pregnant Woman 227 in Pregnancy Presenting in A&E 133 James Hanison and Dougal Atkinson Louise Simcox and Jo Gillham Scenario Section 9: Cardiac Scenario Section 4: Neuraxial Analgesia 30 Chest Pain in a Pregnant Patient 239 Shahid Karim and Sarah Vause 20 Subdural Block in Labour 143 Kathryn Wood and Lorna Howie 31 Peripartum Cardiomyopathy 249 Omar Asghar and Sarah Vause 21 Total Spinal Anaesthesia in Labour 150 Katie Gott and Sophie Kimber-Craig 32 Complete Heart Block in a Pregnant Patient 257 22 Severe Local Anaesthetic Toxicity in Anita Macnab and Kirsty MacLennan Labour 158 Charlotte Ash and Suna Monaghan 33 Cardioversion in a Pregnant Patient with Corrected Tetralogy of Fallot 266 Kailash Bhatia Scenario Section 5: Non-Neuraxial Analgesia Scenario Section 10: Endocrine 23 Respiratory Arrest in a Woman Using 34 Diabetic Ketoacidosis in Pregnancy 277 Remifentanil PCA for Labour 169 Samantha Bonner and Jonathan Schofield Michael McGinlay and Susan Davies Scenario Section 11: Neurological Scenario Section 6: General 35 Subarachnoid Haemorrhage in the Postpartum Anaesthesia Patient 287 Craig Carroll and Daniel Holsgrove 24 General Anaesthesia and Failed Intubation in a Category 1 Caesarean Section 177 Scenario Section 12: Trauma Richard McGuire and Sharon Smith 36 Obstetric Trauma 297 John Butler Scenario Section 7: Haemorrhage 25 Antepartum Haemorrhage and Perimortem Scenario Section 13: Neonatal Caesarean Section 193 37 Newborn Life Support (Preterm Delivery) 305 Kenneth Ma Jonathan Hurst 26 Vasa Praevia 202 Shimma Rehman vi 27 Postpartum Haemorrhage 208 Index 315 Pavan Kochhar and Stuart Knowles mebooksfree.net Contributors Omar Asghar Laura Coleman Cardiologist Anaesthetist Manchester Heart Centre Manchester University NHS Foundation Trust Manchester, UK Manchester, UK Charlotte Ash Samantha Cox Anaesthetist Obstetrician Health Education North West St Mary’s Hospital Speciality trainee, UK Manchester, UK Dougal Atkinson Susan Davies Intensivist Anaesthetist Manchester University NHS Foundation Trust Manchester University NHS Foundation Manchester, UK Trust Manchester, UK Kailash Bhatia Anaesthetist Shuayb Elkhalifa Immunologist Manchester University NHS Foundation Trust Manchester, UK Manchester University NHS Foundation Trust Manchester, UK Sophie Bishop Anaesthetist Joanne Gillham Manchester University NHS Foundation Trust Obstetrician Manchester, UK St Mary’s Hospital Manchester, UK Samantha Bonner Obstetrician Katie Gott St Mary’s Hospital, Anaesthetist Manchester, UK Health Education North West Speciality trainee, UK Annemarie Brown Emergency Medicine James Hanison Royal Liverpool and Broadgreen University Intensivist Hospitals Trust Liverpool, UK Manchester University Hospitals Foundation Trust John Butler Manchester, UK Emergency Medicine and Intensivist Mark Hellaby Manchester University NHS Foundation Simulation Education Network Manager Trust Manchester, UK NHS Health Education England Craig Carroll Daniel Holsgrove Neuroanaesthetist Neurosurgeon vii Salford Royal Foundation Trust Salford Royal Foundation Trust Salford, UK Salford, UK mebooksfree.net Contributors Lorna Howie Al May Anaesthetist Anaesthetist Manchester University NHS Foundation Trust Scottish Centre for Simulation Manchester, UK Glasgow, UK Jonathan Hurst Michael McGinlay Neonatologist Anaesthetist Liverpool Women’s Hospital Health Education North West Liverpool, UK Speciality trainee, UK Simon Hyde Richard McGuire Gynaecological Oncologist Anaesthetist Mercy Hospital for Women Health Education North West Melbourne, Ausralia Speciality trainee, UK Shahid Karim Michelle MacKintosh Cardiologist Gynaecologist Manchester Heart Centre St Mary’s Hospital Manchester, UK Manchester, UK Sophie Kimber-Craig Anaesthetist Simon Mercer Trauma Anaesthetist Royal Bolton Hospital Bolton, UK Aintree University Hospital NHS Foundation Trust Liverpool, UK Stuart Knowles Anaesthetist Yara Mohammed Obstetrician Health Education North West Speciality trainee, UK St Mary’s Hospital Manchester, UK Pavan Kochhar Anaesthetist Kristen Moloney Fellow in Gynaecologic Oncology Manchester University NHS Foundation Trust Manchester, UK University of Melbourne Victoria, Australia Kenneth Ma Suna Monaghan Gynaecologist Anaesthetist St Mary’s Hospital Manchester University NHS Foundation Trust Manchester, UK Manchester, UK Kirsty MacLennan Mark Murphy Anaesthetist Clinical Skills and Simulation Manchester University NHS Foundation Trust Training Manager Manchester, UK Royal Liverpool and Broadgreen University Hospitals Trust Kim Macleod Liverpool, UK Obstetrician St Mary’s Hospital Jenny Myers Manchester, UK Obstetrician St Mary’s Hospital Anita Macnab Manchester, UK Cardiologist viii Manchester University NHS Foundation Trust Manchester, UK mebooksfree.net Contributors Debra Nestel Cliff Shelton Professor of Simulation Education in Healthcare Anaesthetist Monash University for Health & Clinical Education, Health Education North West Monash University Speciality trainee, UK Professor of Surgical Education David Simcox Deparment of Surgery Haematologist University of Melbourne Royal Liverpool University Hospital Victoria, Australia Liverpool, UK Owen O’Sullivan Louise Simcox Anaesthetist Obstetrician UL Hospitals St Mary’s Hospital Limerick, Ireland Manchester, UK Shane O’Sullivan Andrew F. Smith Anaesthetist Anaesthetist UL Hospitals Royal Lancaster Infirmary and Lancaster University Limerick, Ireland Lancaster, UK Andrew Parkes Sharon Smith Anaesthetist and Anaesthetic Allergy Expert Anaesthetist Manchester University NHS Foundation Trust Manchester University NHS Foundation Trust Manchester, UK Manchester, UK Ian Parkinson Sarah Vause Anaesthetist Obstetrician Royal Lancaster Infirmary St Mary’s Hospital Lancaster, UK Manchester, UK Samiksha Patel Melissa Whitworth Obstetrician Obstetrician St Mary’s Hospital Manchester, UK St Mary’s Hospital Shimma Rehman Manchester, UK Obstetrician Kathryn Wood St Mary’s Hospital Anaesthetist Manchester, UK Sheffield Children’s Hospital Jonathan Schofield Sheffield, UK Diabetologist Stephanie Worton Manchester University NHS Foundation Trust Obstetrician Manchester, UK St Mary’s Hospital Emma Shawkat Manchester, UK Obstetrician St Mary’s Hospital Manchester, UK ix mebooksfree.net Foreword Simulation is now firmly established within medical the practical barriers that can prevent the development education at undergraduate and postgraduate levels. of local simulation training. The clinical scenarios are Increasingly multiprofessional team-based, simula- all presented in a standardized format to ensure easy tion is being undertaken to improve the performance navigation. of the clinical workforce and thus clinical outcomes, in Crucially the book also contains a powerful section a variety of emergency situations. The maternity unit about the role of Human Factors, providing an invalua- is an area with an abundance of emergency situations ble context to the simulation scenarios. Raising aware- amenable to, and that would benefit from, team-based ness and promoting Human Factors principles and simulation training. The pros and cons of high- versus practices in healthcare and embedding an understand- low-fidelity simulation are often debated, with each ing of Human Factors into clinical training are major having its own relative merits. There is one message commitments of the Human Factors in Healthcare that is consistent – undertaking simulation training Concordat. This was published in 2013 by the National is better than none at all. Even for low-fidelity simula- Quality Board and signed by multiple stakeholders tion barriers still exist; devising a ‘good’ scenario, who including the CQC and the GMC. should be involved, what kit is required and what key I congratulate all the contributors on putting elements of clinical practice need to be demonstrated together what I’m sure will become the ‘go to’ book on in the scenario? For individual units and clinicians simulation in the maternity unit. addressing even these simple aspects requires a sig- Dr Nuala Lucas nificant amount of work. This publication, serving as Consultant Anaesthetist, Northwick Park a brilliant ‘simulation recipe book’ removes many of Hospital, UK xi mebooksfree.net
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