This simulation-based curriculum is designed to train anesthesia and OB/GYN providers in the diagnosis and management of obstetric hemorrhage, particularly postpartum hemorrhage (PPH), most commonly caused by uterine atony. PPH occurs in approximately one in ten deliveries and carries a maternal mortality rate of up to 17% (p.4). The curriculum provides learners with an opportunity to practice emergency response in a realistic but risk-free environment using multidisciplinary teamwork.
The program focuses on:
-
Early recognition of hemorrhage
-
Implementation of obstetric bleeding emergency protocols
-
Pharmacologic and anesthetic management
-
Resuscitative interventions
-
Crisis resource management (CRM), including leadership, communication, and decision-making
Simulation scenarios replicate operative delivery complications progressing to uterine atony, hemorrhagic shock, and disseminated intravascular coagulation (DIC), requiring coordinated team-based intervention (pp.16–18).
Target Learners
According to page 5, the intended participants include:
Primary Learners
- Senior Anesthesia Residents
- Anesthesia Fellows
- Certified Registered Nurse Anesthetists (CRNAs)
Secondary Learners
- OB/GYN Residents
- OB/GYN Fellows
- Obstetric and Anesthesia clinical personnel
Equipment Needed
The simulation environment is configured to replicate an operating room setting (p.13), including:
Simulation & Monitoring
- SimMama (modified Laerdal SimMan manikin)
- Standard ASA monitors (ECG, NIBP, SpO₂, ETCO₂)
- Fetal heart monitoring strip
- Spinal simulator
- Regional anesthesia tray
Anesthesia Equipment
- Anesthesia machine and breathing circuit
- Airway equipment (ET tubes, LMAs, oral/nasal airways)
- Infusion pumps
- Arterial and central line setup
- Blood warming equipment
- Rapid transfusion device or pressure bags
Surgical & Scenario Materials
- Surgical instruments and drapes
- Suction container and Yankauer
- Fake blood and labeled blood products
- IV lines and fluid bags
Emergency & Circulatory Supplies
Detailed equipment listed in Appendix I (pp.35–37) includes:
- Oxytocin
- Ephedrine
- Phenylephrine
- Etomidate
- Ketamine
- Succinylcholine
- Calcium chloride
- O-negative blood units
- FFP and cryoprecipitate
- Hotline/blood tubing systems
Estimated Time to Complete Activity
- Total Duration of Training: 2 hours (p.4)
- Recommended Group Size: 3–5 trainees per session (p.4)
- Course Frequency: 6–10 sessions annually (p.4)
Simulation scenario progression (spinal anesthesia → uterine atony → bleeding emergency → hemorrhagic shock) typically unfolds over a 15–25 minute active case period followed by structured debriefing (pp.16–18, 21–22).