Calling for help in obstetric cardiac arrests
Recent investigations found delays in calling the full emergency team and problems accessing maternity areas during obstetric cardiac arrests.
Case examples:
- Antenatal ward cardiac arrest: Some cardiac arrest team members could not get into the antenatal ward because of swipe card access restrictions, following an adult cardiac arrest call for a mother in the third trimester of pregnancy. The initial call did not alert obstetric anaesthetists or senior intensive care staff.
- Intensive care unit cardiac arrest: After a cardiac arrest was recognised in a woman in the third trimester of pregnancy in intensive care, a ‘2222’ adult cardiac arrest call was made. This did not alert the neonatal and obstetric team members, who were fast bleeped separately in successive calls. Obstetric anaesthetists were not called in the ‘2222’ calls that were made.
Safety prompts
- Do you have a separate obstetric or maternal cardiac arrest call in your hospital?
- In all areas of the hospital where a pregnant woman may be receiving care, how do staff know which emergency obstetric bleep calls are available, including how to get help in a maternal cardiac arrest? Are there any visual aids, for example near the telephone, to support the correct wording for each recognised emergency ‘2222’ call?
- How do call operators at switchboard confirm with ‘2222’ call makers that a recognised emergency call is being made?
- How do staff know which clinicians will be receiving the ‘2222’ bleep?
- Does the ‘2222’ bleep call in an obstetric cardiac arrest summon all members of the team who are immediately required, including senior team members, in one call?
- Do annual resuscitation training updates for each staff group highlight the differences between adult (non-pregnant) and maternal cardiac arrest protocols and calls?
- When an obstetric cardiac arrest occurs in any area, how do you ensure that all members of the cardiac arrest team and the maternal cardiac arrest team can access that area, without delays?