A patient presents to the emergency department reporting persistent vaginal bleeding 90 minutes after delivering her second child. Her recorded vital signs include a blood pressure of 85/55 mmHg, heart rate of 120 bpm, and respiratory rate of 24/min. What should be the first step in managing this patient?
Directly administer 4 units of packed red blood cells
Administer uterotonic medications
Administer intravenous isotonic crystalloids
Perform an immediate bedside ultrasound to evaluate for retained products of conception
In cases of significant postpartum hemorrhage, as indicated by hypotension and tachycardia, immediate fluid resuscitation with isotonic crystalloids is paramount to stabilize the circulatory system. This step precedes specific treatments such as administration of O-negative blood or uterotonics; it primarily aims to maintain organ perfusion while further management plans are instituted.
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BCEN CEN
Gastrointestinal, Genitourinary, Gynecology, and Obstetrical
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