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Obstetrics & Gynecology:
doi: 10.1097/AOG.0000000000000233
Contents: Original Research

Use of a Novel Visual Aid to Improve Estimation of Obstetric Blood Loss

Zuckerwise, Lisa C. MD; Pettker, Christian M. MD; Illuzzi, Jessica MD; Raab, Cheryl R.; Lipkind, Heather S. MD

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OBJECTIVE: Visual estimation of blood loss is often inaccurate and imprecise. Obstetric bleeding requires expedient identification and intervention to prevent maternal morbidity and mortality. We aimed to create a visual aid to improve accuracy of estimated obstetric blood loss.

METHODS: We designed a pocket card containing images of blood on common obstetric materials to serve as a visual aid. We created six stations with known volumes of artificial blood using materials from standard delivery kits. Obstetric providers recorded visually estimated blood loss across a variety of volumes and materials before and after receiving our visual aid. We assessed the effects of blood volume, clinical role, and years of experience on accuracy of estimation.

RESULTS: One hundred fifty-one participants assessed six stations. We categorized participants by percent error of estimated blood loss before and after receiving our visual aid. We found a significant improvement in accurate assessments for all provider types after intervention across four of the six volumes (P<.001). In a posttest survey, 90% of participants (n=136) reported subjective improvement in estimation ability. Provider type affected accuracy before intervention in two of six stations (P=.01 and P=.03). This difference persisted in one station after intervention (P<.01). Years of experience did not correlate with accuracy of blood volume estimation in five of six stations (P>.05).

CONCLUSION: A visual aid depicting known volumes of blood on obstetric materials can improve accuracy of blood volume estimation among obstetric providers of varying types and with varying years of experience.


© 2014 by The American College of Obstetricians and Gynecologists.


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