Swaraj Hospital & Research Institute, Bolangir

 

 

 

 

 

 

 

 

 

 

 

 

  Swaraj Hospital & Research Institute (Schematic Flow for Rapid Clinical Use) A. TRIAGE & IMMEDIATE ASSESSMENT (Within 10 Minutes) 1. CRITERIA FOR "SEVERE" PREECLAMPSIA (Any ONE of the following): Severe Hypertension: Systolic BP ≥ 160 mmHg OR Diastolic BP ≥ 110 mmHg (on 2 readings, 15 min apart). Symptoms: Persistent severe headache, visual disturbances, epigastric/RUQ pain, nausea/vomiting. Significant Laboratory Abnormalities: Thrombocytopenia (Platelets < 100,000/µL) Elevated Liver Enzymes (AST/ALT > 2x ULN) + symptoms Serum Creatinine rising (>1.1 mg/dL or doubling) Pulmonary Edema New-onset cerebral or visual disturbances 2. IMMEDIATE ACTIONS: Alert: Senior Obstetrician, Anesthetist, Neonatologist. Monitor: Continuous BP, Pulse Oximetry, Fetal Heart Rate (CTG). IV Access: Secure two wide-bore IV lines . Investigations Stat: CBC, LFT, RFT, LDH, Coagulation...

  1. Immediate Patient Assessment a.        Check vital signs: Blood pressure, heart rate, respiratory rate, oxygen saturation, and temperature. b.        Airway patency: Ensure endotracheal tube, tracheostomy, or airway adjuncts are secure. c.        Level of consciousness: Assess response to verbal/tactile stimuli. d.        Pain and comfort: Evaluate pain score and administer prescribed analgesics if needed. 2. Stabilization Before Transfer a.        Hemodynamic stability: Confirm the patient is not in shock or unstable. b.        Fluid balance: IV lines should be patent, fluids running as prescribed. c.        Drainage tubes/catheters: Check patency, secure placement, and ensure no leakage. d.        Dressings: Inspect sur...

The definitive treatment of preeclampsia is the delivery of the placenta. The timing of delivery depends on gestational age, the severity of preeclampsia, and maternal and fetal conditions. Another important aspect in the management of severe preeclampsia is the control of hypertension. A. BP control 1.        Arterial pressure greater than 160/110 mmHg in preeclampsia can increase the risk of complications, and it should be controlled. 2.        BP control should only be done in the ICU, preferably with arterial line monitoring. 3.        BP control should also be done along with fetal monitoring. Avoid sudden falls in BP as it can result in fetal distress. 4.        The goal of BP control is a 15–25% reduction in the mean arterial pressure, and a reduction of pressure to baseline BP levels (<140/90 mmHg) rather than normal BP, should be avoided as ...