Nursing Simulation Scenario: Postpartum Hemorrhage

This video is one in a series created for nursing and healthcare educators for use in a variety of settings. Complete information about this scenario, from set-up to debriefing questions, can be found at cms.montgomerycollege.edu/nursingsims/

[@drp2200]

Fabulous simulation, very realistic, thank you for sharing this openly. This will be a very helpful teaching tool for nursing students.

[@bugga179]

I wish I could talk so firm and clearly!!!

[@Pinksuga07]

I'm an actor playing an OBGYN in a short film, so this was insanely helpful for my research :)

[@swiftdaggas]

where can we see the short film?

[@hannahtjoa8101]

Brilliant execution and composition. Cheers to Montgomery College for this very educational piece!

[@inutukasote7908]

Great team work and execution! Thank you for helping me understand what to expect in my clinical for postpartum hemorrhage!

[@scottmasih9175]

I really needed to see this for my OB clinical. Thanks for making this quality vid!

[@meredithmajerus9235]

These are so helpful and educational!! Thank you to this school for making these wonderful videos.

[@josiedoyle1600]

This happened to me last week on xmas day. Most terrorfying moment of my life. I thought my family were going to loose me on xmas day and my boyfriend left to raise a child alone. Was only 850mls blood loss in the end but when your lying on your back you dont know whats going on. God bless midwives and drs who save lives. Watching this helped me understand what happened to me.

[@chloecoughlan9896]

I know exactly how you feel!! I gave birth nearly 5 months ago and lost 1.5 ltrs of blood altogether, I was so happy I had my baby that I wasn’t even aware of the amount of blood I lost

[@bettyphiri6512]

Bless you

[@angelicataylor4875]

This was very good and educational. Helped me understand from the other side. This just happened to me today. God is good and blessed all you docs and nurse's!

[@courtneymcgregor2542]

this is such an awesome simulation. Great job!

[@vanessaarline349]

Awesome simulation! I first became aware of your work, when I showed your You Tube video in a presentation on incivility. It was very well received and outstanding. Excellent scenario elements! I teach OB now and need this kind of help in formulating my ideas.

[@ashhappyface]

I’m not in the nursing program yet so just interested right now about the kind of stuff I’ll be doing during nursing school. And this stresses me out lol😳

[@akhoneybee9076]

Having managed a hemorrhage myself. You get used to it and know what to look for. It’s always stressful, but you rely on tour training and react as it comes. 😊

[@tummetje1240]

They should explain more to the patient. When she asked what's going on the only response she got was that she was doing well. She should have been told what happened

[@copperlight]

wow that was awesome. I felt like I was watching a movie. I was holding my breath for her and everything. Great job guys.

[@binbinky78]

As always these simulations are fantastic & so helpful to nursing students....so thankful for your quality content

[@SRNAreview]

Amazing video!! Professional, and very helpful to this nursing student. Thank you!

[@MissAlexis911]

Fantastic video! Thank you !

[@mirimel1423]

That is the best simulation I've ever seen,good acting,so realistic,thank you for the actors😊🙏

[@dancewithoutme]

I don't know how I got here but I commend you for making videos that uses diversity and professionalism - nurses comiing out of your program have to be absolutely awesome

[@gemahoeksema6798]

I know that there was a lot going on and they had to be focused on what to do, but it took 3 times for the patient to ask what was happening to her for anyone to give her an answer.

[@aaronjames3228]

That's not the top priority in my opinion. Stabilize the patient asap

[@briannag.9486]

this was amazing! thank you!

[@dawngraves3067]

Excellent demonstration for teaching

[@kmina9972]

Great job nursing students! Too bad this year students are not having helpful experiences like this

[@Kriistall7]

So terrifying watching this. Its exactly what happened to me

[@josiedoyle1600]

Same

[@kimbaker3232]

Me too 😢

[@nicholasbutorovichg4409]

Kim Bakeuur h

[@SuperICEMAN15]

SIMULATION!?! THIS WAS BETTER ACTING THAN THE MED SHOW IM WATCHING ON NETFLIX!!!!💯

[@termfivenursingchannel6645]

Toradol? I had to idea this could be given with active bleeding. Great teamwork and exercise!

[@KManwarren]

Well done and everyone received care by those who were prepared and calm.

[@kah_lan]

Thank you for this video. This is going to help me tremendously. Very detailed. Thank you! Thank you!

[@nmiller021]

Awesome simulation lab!

[@sandyyveee]

Thank you for this video very helpful!

[@elizabethcw9378]

Excellent task delegation

[@peterwaswa1171]

Excellent team work.

[@marie.s9995]

Great content. Thank you!

[@bettybraima6187]

This is fantastic..

[@ttselha64]

I’m a retired RN. I had a postpartum hemorrhage due to a tear from a mid forceps delivery.

[@MargieB51]

Outstanding very much respect for all the people that Reenacted what can happen after labor I have not seen that good at acting since dances with wolves excellent ladies and gentlemen

[@ambrosiaaa9064]

We Stan diversity

[@wsheri11]

Wow this was really realistic I really liked it thanks!

[@johannaharris1718]

Diversity is on point

[@drunkpilates]

is that miss brown's white mom or lesbian partner?

[@kimmyaguilar5408]

drunk pilates i think it’s lesbian partner

[@kawtharbakhach5848]

@@kimmyaguilar5408 but she just....gave. ...birth lmao

[@allybrookeaf79]

@@kawtharbakhach5848 lesbians can have children too ya know just not with each other biologically 🤨

[@hannahtjoa8101]

Agreed

[@krissyko3864]

this really helps a lot, thank you so much

[@69kalil]

Excellent video !! realistic, and very educative. For me it was wonderful resource for to remember a shift delivery.

[@thompsonkendra44]

thank you.

[@Sigridr763]

Great sim!

[@che8527]

lovely video, very realistic. should've explained more about what's going on to the patient tho and not use toradol when there's an active bleed

[@gemsancho8480]

I thought the same thing

[@Intuitive1]

I love watching the simulations.

[@rachelaltman3783]

Decent simulation except I the nurse should initially explain" you are bleeding more than average I am calling for help. " In this situation toradol is contra-indicated .This is critical as it is contra-indicated for bleeding and also not fast acting. We usually give fentanyl. After foley placement and manual removal of clots and placental fragments we would want to consider Methergine in the scenario as well as pitocin, misoprostil. Remember pt will need antibiotic afterwards. QBL more accurate than EBL. Also important to mention possible indication for Type and screen and available blood products.

[@TubnQT]

Double like. Also, it seems to go about double this speed in real life, with patient either screaming or unconscious, not as quiet as this one.

[@NikkieRoxxx]

Yeah, screaming for EFFECTIVE pain control. Or do you just tjink "its just a woman"

[@lovejoy_23]

I had a PPH situation at a birth center with my first delivery. And although getting my uterus massaged was very painful, I wasn’t screaming. I’m also grateful to not have a host of pain medication offered because I wouldn’t want them in my system anyhow. While the midwife massaged and managed the blood loss, another midwife started an IV with pitocin. Thankfully I didn’t need a transfer (I was very close to getting transferred) and was able to discharge home with our baby only 2-3 hrs later with post-partum care instructions. My husband was also given instructions to accompany me to the restroom and only take quick showers until the midwife followed up with me in 2 days. In the following days, loading up on beef liver, iron rich foods and lots of liquids made a huge difference in my energy levels after all that blood-loss.

[@thajejigthbuzru4721]

Thanks.for sharing! Very helpful video for nursing students.

[@teresadues9531]

Great Job!

[@SuperBerya]

AWESOME!

[@bettybraima6187]

Great job guys

[@NinaSchexnider]

great video and the main nurse was awesome!

[@sandrita9643]

Thank you very helpful for the nclex.

[@Hobosdkcheese]

This was great!

[@Spookyghoul777]

Love this !

[@yourarisgirl1927]

Great simulation! 👍🏼

[@TubnQT]

Oops didn’t mean to click the thumbs down. A slip of my finger!

[@halimahyadi7987]

very created video, so helping for imagening the real situation

[@msprettynpink25]

Awesome Simulation!!

[@leeanningram9204]

Great job

[@Vahriin]

I think the Spo2 device was placed on backwards.

[@sagittal6950]

Did she really memorize the VS that quickly to relay to the midwife when she asked?

[@iamyoonis]

I'm going to be doing a similar simulation soon... except with only three people in the team

[@SpeedyCutz]

amazing stimulation

[@tylerstudley8474]

Excellent work. Thank you

[@grace2be]

Phenomenal SIM!

[@Honeypepper.]

im shooketh, I can't be this profession too high stress!

[@TubnQT]

Imagine this times 8 patients at once, all in different halls, plus 8 doctors calling you as well as your supervisor. Also, you have to push a 50 pound computer into each room, and push a 50 pound rolling crib to and from the nursery for labs and procedures.

[@cdsonly]

Nice touch with blood on glove.

[@valentinyazbek2980]

how do you guys memorise all the infos of the patients ? I am a nursing student and i tend to forget my patients infos i have to constantly look for it .

[@marypetrauskas5008]

compassion nice!!!

[@bethanywhite877]

I had preeclampsia. I hemorrhaged with my second child. Uterus massage looks nice and pain free in this video…lol. My nurse was on a step stool or something, over the top of me, pushing on my uterus as hard as they could. People running everywhere. The people running around was what terrified me honestly. I had no idea how dangerous preeclampsia is until years later. Probably a good thing to be ignorant to the danger I was in and my kids. Diagnosed at 22 weeks with first and 24 with second. Bed rest, induced one month early on both, perfectly healthy babies. Just low birth weights of 4 lbs. I would of rather gone through labor and delivery again than suffer with a hemorrhage.

[@sandhiller49]

Toradol not a good choice, contraindicated in bleeding situations, otherwise nice training video, need a little more explanation to patient at beginning

[@kiaanointed1360]

well done

[@premiumview4248]

Well done

[@jaeratkay1846]

Loved the report, wish they went this slow/detailed irl 😅

[@bluejedi723]

this is so awesome....everything is going so normal, you think she's okay, just normal checking ect and then out of nowhere things go south fast

[@misswolflover789]

Wow that was good!

[@alexisstreckenbach6801]

This is great! What is EBL?

[@ashleycarter5963]

Estimated bleeding loss

[@rubyellis.5472]

Pieces of the placenta get left behind because the doctors and nurses are pulling on the placenta to get it out instead of letting it come out on its own in one piece.

[@yuneydelacruz9179]

1. What are the causes of the patient's postpartum bleeding? 2. Do you consider that the nursing management was adequate? Explain why. 3. If you were in a scenario like this, what nursing intervention would you do? Would you do something different from what was seen on stage? Explain why. 4. Do you understand that communication between health professionals, the patient and the family member was adequate? Explain why. 5. Are the medications used for bleeding; were they adequate? Explain your answer. 6. What did you learn from the stage?

[@zoilaquintana9115]

Hola yunior el medicamento usado para el sangramiento fue el correcto

[@lovejoy_23]

To answer number 1: she had multiple factors that put her at risk for PPH. Her main cause seemed to be placenta fragments left behind, one reason why inspecting the placenta after delivery is very important. Precipitous delivery of a large baby is another factor. That happened to me.

[@gaggymott9159]

Why Ketorolac?

[@asluzun5400]

harikaa

[@sandhiller49]

tachycardia is a sign too, that something happening

[@TubnQT]

Yes, and she had only voided 150, as well as a >4000 g baby, precipitous delivery.

[@iPinkerbell]

3:04

[@aprilotic3717]

I wish we have that many personnel in our unit. Unfortunately, all of the things being done on this patient is only done by a nurse and a doctor in our facility. This simulation is fantastic. In my experience though, when a patient is having PPH, they are always in a lot of pain so I make sure to check the patient frequently in the 2 hours after delivery.

[@soleilsoleil716]

Why an NSAID during a bleed?

[@mattcandiepetty3933]

My EXACT thought watching this! Other than that, it was well done! We would definitely AVOID all NSAID's until stable

[@jamesrowlandson7308]

I thought the same thing. Ketorolac is contraindicated for hemorrhage due to platelet function inhibition!

[@NikkieRoxxx]

because nowadays, eveyrone's afraid to give REAL pain meds because of the fear of addiction .. ridiculous in such a situation!!! they should have given propofol, no pain: patient gone!!

[@amandag2089]

@@NikkieRoxxx we give Fentanyl for a vaginal sweep. Toradol ain’t gonna do anything!

[@NikkieRoxxx]

@@amandag2089 even better: propofol!! quick, efficient, and the waking up is also quick!

[@sarahbadumedi6571]

i didnt know you can remove rpoc's with your hand🤔i dont think the doctors would let me do that

[@theneed2comment]

"Have a baby" they say. "It's a beautiful thing" they say. smh.

[@suri7502]

Love

[@shanadumplins8462]

Why Cytotec as opposed to Oxytocin?

[@Untamed_ayla]

in the beginning of the video i believe she was on pitocin so i guess it wasnt working

[@akhoneybee9076]

Midwife here. Pitocin (oxytocin) is usually used first since it has a short half life and we want to start with that. If if doesn’t work after a single dose, a double may be used as well as Cytotec which has a similar action of quickly causing the uterus to contract and close the blood vessels. Cytotec is used in situations like these rectally most often in my area for its quicker action that way. I also find it lasts longer.

[@rejeanelc8797]

👏🏻👏🏻👏🏻👏🏻

[@viktoriia7382]

Who is primary nurse here?

[@alicjarojas7736]

I’m confused why is toradol 30mg IVP ordered for pain when she’s already hemorrhaging?? So we want her to bleed more now?

[@donhowell6667]

@2:08 Who brings their business partner to a birthing?

[@laurens7431]

I hate how quickly thing can go badly in postpartum! it's really all fine until it's really not.

[@tungstenwhizard4361]

10/25 Bday? 😂That's my birthday!!!!

[@janicecooper875]

Well show us the baby

[@southern-samurai]

How many mls of blood is expelled to classify the scenario as fully Woke?

[@NikkieRoxxx]

putting their hand in uterus WITHOUT ANAESTHESIA?!?!?!

[@cassiem7157]

I think the risk of bleeding out and dying outweighs the pain of the hand in the uterus.

[@hha8171]

@@cassiem7157 well said

[@ladiibug3318]

I’ve had this done to me. It was extremely painful 😖

[@NikkieRoxxx]

@@cassiem7157 a propofol injection kicks in 5-10 seconds. Taking an appendix out is also lifesaving.... its just a chauvinistic excuse "because itsxa woman"

[@NikkieRoxxx]

@@ladiibug3318 sue the bastards. Hrre in the Netherlands tgey put you under for this!!!!!

[@lovelydae7455]

Honestly most my nurses and doctors were foreign

[@kungfu82able]

Didn't even need to run blood.

[@risalockwood1978]

apgar?

[@423moore]

9

[@kdhowe31]

It is a quick assesment of well being score of babies following birth

[@daniellecoffey8451]

9/9 she said it in the shift report