Postpartum Haemorrhage Drills and Skills Building

The Sr. MARCH-OT approach is borrowed from the management of exsanguination haemorrhage in trauma care. This applies well to acute PPH haemorrhage control, hence this conceptual paper to change the ALSO and PROPMT algorithms in severe PPH management. The importance of skilled maternity professional and regular drills in managing massive PPH cases is paramount and cannot be over emphasised. The historical approach borrowed from the ACLS approach of following the DR. ABCDE algorithm does not address the points of emphasis in manoeuvres that help quickly control the bleeding, “Closing the tap”. Most obstetric patients are young and have the physiological reserve to maintain the alertness, Airway and Breathing in the early stages of bleeding hence emphasis should be on closing the tap and replacing the red cells and clotting factors while not neglecting the support to Airway and ensuring patient is breathing