Acute Care/Trauma Surgeon's role in obstetrical/ gynecologic emergencies (The OBCAT Alert)
10.5847/wjem.j.1920-8642.2016.04.006
- Author:
Lee K. SEONG
1
;
Carrillo H. EDDY
;
Rosenthal ANDREW
;
Sanchez RAFAEL
;
Kiffin CHAUNIQUA
;
Davare L. DAFNEY
Author Information
1. Division of Acute Care Surgery and Trauma
- Publication Type:Journal Article
- Keywords:
Obstetric hemorrhage;
Postpartum hemorrhage;
Damage control packing;
Acute care surgery;
OBCAT
- From:
World Journal of Emergency Medicine
2016;7(4):274-277
- CountryChina
- Language:English
-
Abstract:
BACKGROUND: Overwhelming hemorrhage or other intra-abdominal complications may be associated with obstetrical or gynecologic (OB/GYN) procedures and may require the surgical training of an Acute Care/Trauma Surgeon. The OB Critical Assessment Team (OBCAT Alert) was developed at our institution to facilitate a multidisciplinary response to complex OB/GYN cases. We sought to review and characterize the Acute Care/Trauma Surgeon's role in these cases. METHODS: We conducted a retrospective review of all emergency consults during an OB/GYN case at our institution from 2008 to 2015. An OBCAT is a hospital based alert system designed to immediately notify OB/GYN, anesthesiology, Acute Care/Trauma, the intensive care unit (ICU), and the blood bank of a potential emergency during an OB/GYN case. RESULTS: There were 7±3 OBCAT alerts/year. Seventeen patients required Acute Care/Trauma surgery intervention for hemorrhage. Thirteen patients required damage control packing during their hospitalization. Blood loss averaged 6.8±5.5 L and patients received a total of 21±14 units during deliveries with hemorrhage. There were 17 other surgical interventions not related to hemorrhage; seven of these cases were related to adhesions or intestinal injury. Seven additional cases required evaluation post routine OB/GYN procedure; the most common reason was for severe wound complications. There were three deaths during this study period. CONCLUSION: Emergency OB/GYN cases are associated with high morbidity and may require damage control or other surgical techniques in cases of overwhelming hemorrhage. Acute Care/Trauma Surgeons have a key role in the treatment of these complex cases.
