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MS WordPerinatologist Corner - C.E.U/C.M.E. Modules
Vaginal Birth After Cesarean
Sponsored by The Indian Health Service Clinical Support Center
8. Management: Drills
Periodic Drills
We have discussed some of the benefits and risk of vaginal birth after cesarean. We have discussed the risk factors and strategies to manage patients with those risks. Yet, all this discussion and data does not necessarily mean that the assembled team attending your patient's birthing process will be able to translate your facility's resources into a great patient outcome every time.
The risk of symptomatic uterine rupture is so rare that many maternity care providers may not see one in their lifetime, so you should consider performing periodic drills with your whole labor and delivery team to be prepared. These drills should be realistic and should take place on your labor and delivery unit.
If you know all the data and understand all the risks, then why perform and artificial drill?
How else will you find out that the Bicitra is actually in the Pyxis machine and immediately available without a code or thumb print scan?
How else will you learn how to deal with the trails of cords and monitor wires while you notice that the patients' IV line has just gotten dislodged as you sped through the doorway that was a little too tight?
The list is endless and you will only learn about some of these contingencies if you go through realistic drills.
By the way, 'having said all the above, ...JCAHO
is also becoming quite keen to hear that you have been performing periodic drills.
Here is one helpful resource:
Emergency Delivery Simulations: How to DevelopTeamwork (P P T 728 k)
