Approximately ten minutes later she complained of shortness of breath and then proceeded to experience a full cardiac arrest. AFE remains a clinical diagnosis New Proposed Mechanism of AFE (Leighton, 2013) Case Study A term, G 3 P 2 laboring patient had an intrauterine pressure catheter placed for better assessment of uterine contractions. § Recommendation 2: Use of a specific diagnostic laboratory test to confirm/refute a diagnosis of AFE is not recommended. , 2016) Thromboxane Pulmonary Vasoconstriction Serotonin Vagal Reflex Atropine Ondansetron Bradycardia And Peripheral Vasodilation References § Hypothesis: Amniotic fluid triggers platelet aggregation within the pulmonary vasculature § A systematic literature review was performed on articles related to AFE that were published from 1966 – March, 2015. § Recommendation 7: Assessment for coagulopathy/early aggressive management of bleeding with massive transfusion protocols (SMFM, et al. § Recommendation 6: Initial management for AFE should include oxygen/ventilation, vasopressors/inotropic agents. § Recommendation 5: Immediate delivery of a fetus >23 weeks gestation should be performed following cardiac arrest with AFE. § Recommendation 4: A multidisciplinary team should be involved with care of AFE patients. § Recommendation 3: Immediate CPR and ACLS protocols should be instituted in patients who develop cardiac arrest associated with suspected AFE. com 480 -323 -3895 Current SMFM Recommendations A-OK Protocol Ketorolac § Recommendation 1: In laboring or recently delivered women presenting with sudden cardiorespiratory collapse, a diagnosis of AFE should be considered. Health Scottsdale Shea/Osborn Medical Centers cheryl. D, WHNP-BC, RNC-OB, RNFA Women’s Health Nurse Practitioner Honor. Health Scottsdale Shea/Osborn Medical Centers sheryl. Parfitt, MSN, RNC-OB Clinical Educator – Obstetrics Honor. § Recent suggestions for diagnostic criteria are the presence of a classic triad of hemodynamic and respiratory comprise accompanied by DIC (Clark, et al. § There is no international consensus regarding diagnosis criteria or treatment plan for AFE. § The low incidence of AFE limits practitioners/medical personnel's experience in management of this condition. § In the USA and Europe, AFE is the second leading cause of maternal death (13. Health Scottsdale Shea/Osborn Medical Centers, Scottsdale, AZ Background § Amniotic fluid embolism (AFE) is an unpredictable, unpreventable, and potentially devastating complication in obstetrics. UTILIZING THE A-OK PROTOCOL A Novel Approach to AFE Treatment Sheryl E.
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