Hospitals Train to Curb Maternal Mortality
[ad_1]
Dying during pregnancy, delivery, or soon after having a baby is more common in the U.S. than in any industrialized nation. It’s called “maternal mortality,” and it’s nearly three times more likely for Black women than white women.
To help save lives, a growing number of U.S. hospitals are using obstetric simulation centers where medical teams can practice for life-threatening situations that can happen during labor and childbirth. One of the places doing this is NYC Health + Hospitals/Elmhurst in Queens, NY, which delivers 180 babies in a typical month.
Elmhurst’s Mother-Baby Simulation Center features a specially designed full-body mannequin of color, along with a mannequin infant. The center puts doctors, nurses, and other medical professionals through simulated – but realistic – obstetric emergencies such as maternal hemorrhage, dangerously high blood pressure, sudden cardiac arrest, and emergency C-section. They also train to handle cord prolapse, when the umbilical cord drops through the mom’s cervix into the vagina ahead of the baby, potentially cutting off the baby’s oxygen supply.
Elmhurst serves one of the most diverse communities in the country, with residents from over 100 countries speaking more than 100 different languages in its surrounding neighborhoods, says Frederick Friedman, MD, NYC Health + Hospitals/Elmhurst’s director of OB/GYN Services.
“Our simulation team is very happy that the new mannequin we have to simulate OB complications is a mannequin of color, which is more realistic for our patient population,” Friedman says.
Related: How to Advocate for Yourself as a Pregnant Woman of Color
Practicing for a Crisis
At Elmhurst, some simulations are scheduled to prepare new resident physicians for the most common obstetric emergencies. Others come as a surprise, just as a real life crisis can unfold.
“We might come running down the hallway with a ‘patient’ who has a cord prolapse, requiring emergency delivery — that’s almost always a C-section,” Friedman says. “We’ll yell, ‘Cord prolapse, triage,’ and see how fast we can get the team assembled, how long it takes the anesthesiologist to prepare, how soon we have a scrub nurse ready for surgery,” as if the mannequin “patient” is a real person.
These simulations focus on high-risk situations that don’t happen often, such as severe postpartum bleeding (hemorrhage) or a mother who is having seizures from eclampsia (high blood pressure), Friedman explains. “It’s hard to develop skills in an emergency that might only occur in 1% of cases, where an individual doctor or nurse could go years without encountering it.”
The chance for doctors, nurses, and other medical professionals to gain experience with obstetric emergencies is even lower at hospitals that have fewer deliveries than the busy Elmhurst, says obstetric simulation expert Shad Deering, MD, an OB/GYN professor, specialist in maternal-fetal medicine, associate dean at Baylor College of Medicine, and medical director for simulation at CHRISTUS Healthcare System.
“If you’re doing only 10 deliveries a month, and the risk of postpartum hemorrhage is about 5%, you can go several months to a year without having one,” Deering says. “Obstetric emergencies happen with enough frequency that we really need to be prepared for them — but not enough, especially in lower-volume places, that the teams get the preparation they need.”
Getting Results
Can practicing with even the most realistic mannequin and simulated emergency situation really improve how a medical team performs when there’s a real person bleeding uncontrollably during delivery?
A number of studies say yes. Simulation training has been shown to:
- Reduce injuries to babies that have shoulder dystocia, in which their shoulders are impacted by the mom’s pelvic bones during a vaginal delivery.
- Shorten the time it takes to diagnose cord prolapse and improve its management.
- Reduce the time from deciding that an emergency C-section is needed to delivering the baby.
“Obstetrics is one of the only places in medicine where we have two patients at the same time,” Deering says, referring to the mother and the baby. “This means that we have to very quickly and acutely balance the needs of both patients.”
“Since labor and delivery teams change often, nurses and doctors may not have worked together much before,” Deering says. “We have a constantly rotating team where everyone has to understand their roles and responsibilities and be able to execute them flawlessly at a moment’s notice, when everything is going great until suddenly everything is going wrong.”
Not every hospital can have a large, high-tech simulation lab with expensive, high-quality mannequins. But they don’t necessarily need that kind of a setup, Deering says.
“In a fancy simulation lab, you can ask for blood products and they just show up, which isn’t exactly realistic. But if you’re running a simulation in your regular L&D ward with a relatively inexpensive, mid-range mannequin, you have to run and get your supplies and come back just like you would in reality,” Deering says. “We’ve actually had a situation where we were running an emergency delivery simulation in one room and then were called in to manage the exact same real emergency next door!”
Besides giving labor and delivery teams the opportunity to hone their skills in responding to emergency situations, simulations can help identify specific problems within a hospital’s setup, like access to certain supplies. Understanding how unconscious bias may affect their care decisions is also part of the training.
“When we create simulations, we can build in situations that might help us identify where disparities in care may be, so that we can start to address them,” Deering says. “So it’s not just about ‘Did you give the right medication for hemorrhage?’ but also, ‘How well did you communicate with the patient and family, were there any potential cultural issues you did or didn’t address?’”
As with the new mannequin at Elmhurst Hospital, new obstetric simulators now have more color options, so that hospitals can choose from mannequins with a range of skin tones. “We need these simulators to look like our patients, and now we’re finally able to do that,” Deering says.
He says that every hospital where babies are delivered should have a simulator available to prepare the medical team for emergencies, noting that lower-cost mannequins are available for under $3,000, accompanied by free resources available from the American College of Obstetrics and Gynecology (ACOG) and its “Practicing for Patients” initiative to help make the most of simulation technology.
“To make a real difference in saving the lives of women and their babies, and reduce disparities in care, simulation has to be accessible to everyone and practiced on a regular basis,” Deering says. “We want any size labor and delivery unit in any hospital in the country to be able to do this.”
(For more on maternal mortality, listen to WebMD’s Health Discovered podcast episode with Tonya Lewis Lee on her new Hulu documentary, Aftershock.)
[ad_2]
Source link
Buy Vardenafil 20mg https://levitra.eus/# Levitra 10 mg best price
generic lipitor 80mg atorvastatin 20mg over the counter buy atorvastatin pills for sale
order finasteride 1mg generic order diflucan 200mg online cheap buy diflucan 100mg online cheap
cipro 1000mg pills – buy bactrim tablets order augmentin 1000mg generic
order baycip for sale – myambutol uk augmentin 375mg pills
metronidazole 200mg us – buy generic flagyl online brand azithromycin 500mg
ciprofloxacin over the counter – buy doryx without a prescription buy erythromycin 500mg generic
brand valacyclovir 500mg – diltiazem 180mg over the counter zovirax 800mg cheap
ivermectin pills canada – axetil tablet order sumycin 500mg for sale
how to buy flagyl – order amoxil generic purchase azithromycin online cheap
ampicillin for sale purchase penicillin buy cheap amoxicillin
furosemide 100mg sale – atacand medication captopril 25mg tablet
buy metformin 1000mg sale – buy combivir no prescription lincomycin cost
buy retrovir 300 mg pills – buy generic epivir allopurinol 300mg pills
buy clozaril generic – purchase coversyl generic buy pepcid 20mg generic
buy quetiapine generic – ziprasidone 80mg sale purchase eskalith pill
clomipramine 25mg price – clomipramine where to buy purchase sinequan online
buy hydroxyzine generic – nortriptyline 25 mg cost order endep 10mg generic
purchase amoxiclav – order bactrim 960mg pill ciprofloxacin 1000mg over the counter
buy generic amoxil over the counter – order amoxil generic buy baycip online
order cleocin 150mg sale – cefpodoxime 200mg us buy chloramphenicol online cheap
purchase zithromax pill – order metronidazole without prescription ciprofloxacin 500 mg sale
ivermectin 12 mg for people – aczone online order buy cefaclor 500mg online cheap
order ventolin 4mg online – where can i buy theophylline pill theo-24 Cr
buy depo-medrol for sale – loratadine for sale online astelin sale
clarinex online order – ketotifen 1 mg brand buy ventolin inhalator online cheap
buy micronase paypal – order glucotrol 5mg generic dapagliflozin 10 mg tablet
terbinafine pills – lamisil online order where can i buy griseofulvin
order generic semaglutide 14mg – buy DDAVP cheap purchase DDAVP generic
order generic ketoconazole 200mg – nizoral 200mg pills buy itraconazole 100mg sale
famvir 500mg pills – order generic valcivir 1000mg valcivir without prescription
lanoxin 250mg over the counter – lanoxin 250mg price lasix cost
microzide 25mg ca – lisinopril 10mg for sale order bisoprolol 5mg for sale
oral lopressor 50mg – micardis 80mg price buy nifedipine 10mg
how to get nitroglycerin without a prescription – combipres over the counter buy generic valsartan over the counter
crestor pills employ – crestor online mercy caduet announce
zocor promise – gemfibrozil dress atorvastatin ghoul
viagra professional online maintain – levitra oral jelly online curtain levitra oral jelly blue
priligy lighter – suhagra blank cialis with dapoxetine scholar
cenforce storm – brand viagra pills machine
brand cialis distinct – alprostadil baby penisole temper
cialis soft tabs league – viagra super active pills percy viagra oral jelly fold
brand cialis plunge – forzest polish penisole meat
cialis soft tabs pills crazy – valif online drip viagra oral jelly situation
cenforce online monsieur – kamagra medication brand viagra pills sometime
acne medication except – acne treatment breathe acne medication trap
inhalers for asthma valentine – inhalers for asthma anyone asthma medication pry
uti treatment shield – treatment for uti image uti treatment decent
prostatitis pills stack – prostatitis treatment today prostatitis medications golden
valtrex pills tom – valtrex pills sparkle valacyclovir gear
claritin pills cool – loratadine unhappy claritin pills aware
dapoxetine handle – priligy closer dapoxetine fish
loratadine medication coin – loratadine uncertain claritin pills twin
ascorbic acid way – ascorbic acid protection ascorbic acid delightful
promethazine stre – promethazine within promethazine family
clarithromycin distress – mesalamine guess cytotec pills din
fludrocortisone pills feel – omeprazole pills background lansoprazole eastern
rabeprazole 20mg for sale – buy domperidone 10mg without prescription buy motilium generic
buy dulcolax online cheap – liv52 generic liv52 brand
bactrim generic – order bactrim 960mg pill order tobra 10mg sale
oral hydroquinone – order dydrogesterone purchase duphaston for sale
dapagliflozin 10 mg price – dapagliflozin 10mg generic precose 25mg ca
buy griseofulvin 250 mg for sale – where can i buy lopid brand lopid
order dimenhydrinate 50mg sale – pill risedronate actonel pill
vasotec 5mg generic – order generic doxazosin 2mg latanoprost order online
how to buy monograph – buy pletal pills cilostazol for sale
feldene order online – purchase rivastigmine online buy generic exelon for sale
новые сервера л2 эссенс
Сервера л2
piracetam order online – buy generic piracetam for sale sinemet 20mg cost
buy hydroxyurea generic – order trecator sc without prescription purchase methocarbamol
purchase depakote generic – order aggrenox for sale topiramate 100mg pill
purchase disopyramide phosphate pills – cheap norpace without prescription buy thorazine generic
order cyclophosphamide for sale – meclizine 25 mg ca vastarel uk
purchase aldactone for sale – dilantin 100 mg sale order revia 50mg without prescription
buy flexeril cheap – enalapril drug enalapril 5mg canada
how to get zofran without a prescription – where can i buy ropinirole brand requip 2mg
generic ascorbic acid 500mg – buy isordil pills for sale buy generic prochlorperazine
purchase durex gel online – buy durex condoms sale xalatan drug
minoxidil canada – purchase finpecia sale buy propecia 1mg generic
arava 10mg without prescription – purchase arava generic cartidin for sale
cheap tenormin 50mg – atenolol over the counter buy carvedilol 6.25mg generic
order calan 240mg – buy tenoretic sale buy tenoretic pill
atorlip price – enalapril over the counter nebivolol usa
buy gasex tablets – ashwagandha tablets diabecon over the counter
lasuna price – buy himcolin generic purchase himcolin for sale
finasteride sale – finax where to buy uroxatral 10 mg ca
purchase speman online – himplasia over the counter purchase fincar
trileptal for sale – buy synthroid 150mcg pill buy synthroid 100mcg without prescription
buy imusporin cheap – purchase imusporin online buy colchicine sale
order duphalac generic – cheap mentat generic purchase betahistine generic
order calcort pill – alphagan price brimonidine cheap
buy neurontin 800mg – ibuprofen 600mg pills order sulfasalazine
buy benemid pills – brand carbamazepine 400mg tegretol canada
buy generic celecoxib 100mg – where to buy celebrex without a prescription purchase indomethacin
order colospa 135 mg – buy etoricoxib 120mg for sale cilostazol usa
brand voltaren 100mg – oral aspirin aspirin online
pyridostigmine drug – azathioprine 25mg drug azathioprine 25mg oral
buy rumalaya generic – amitriptyline 10mg cheap purchase endep online cheap
lioresal without prescription – lioresal brand piroxicam drug
voveran usa – cheap diclofenac without prescription order generic nimotop
buy cyproheptadine without a prescription – order generic periactin order tizanidine sale
order mobic without prescription – maxalt online buy buy generic toradol
cefdinir 300 mg drug – omnicef pills cleocin for sale
purchase artane pill – emulgel online order order emulgel cheap
buy isotretinoin 10mg online cheap – accutane 20mg without prescription order deltasone 20mg sale
brand acticin – benzoyl peroxide sale buy generic retin gel
betnovate 20gm cost – adapalene usa cost monobenzone
buy metronidazole 200mg for sale – cheap metronidazole 400mg buy generic cenforce 100mg
buy augmentin 625mg pills – levothyroxine drug purchase levothyroxine
order losartan 25mg for sale – purchase keflex order cephalexin 125mg generic
how to get cleocin without a prescription – cleocin 300mg pill indomethacin 50mg price
order provigil 200mg generic – buy modafinil 100mg sale order melatonin online
eurax us – purchase eurax how to get aczone without a prescription
zyban for sale – purchase orlistat online cheap cheap shuddha guggulu pill
capecitabine 500mg generic – capecitabine 500 mg price order danocrine 100mg sale
buy cheap dostinex – premarin buy online order alesse online cheap
プレドニン処方 – г‚ёг‚№гѓгѓћгѓѓг‚Їе‡¦ж–№ г‚ўг‚ёг‚№гѓгѓћг‚¤г‚·гѓі е‰ЇдЅњз”Ё
гѓ—гѓ¬гѓ‰гѓ‹гѓі е‰ЇдЅњз”Ё – гѓ—гѓ¬гѓ‰гѓ‹гѓійЂљиІ©гЃ§иІ·гЃ€гЃѕгЃ™гЃ‹ イソトレチノインの購入
valif almost – valif online remind buy sinemet for sale
crixivan pill – crixivan order purchase diclofenac gel cheap
buy generic modafinil over the counter – epivir online buy lamivudine online order
brand promethazine – ciplox price lincomycin online
cost ivermectin – order generic tegretol tegretol generic