EDC - "Every Drop Counts"
DEVICES
EDC - Every Drop Counts
Blood Loss Collection System: consists of under-buttocks drapes and a standard bag (as described by the WHO) for collecting blood in a vaginal delivery.
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This allows blood to enter a container with minimal spillage
Ultrasound sensor: detects fluid levels in the container by converting electrical energy into acoustic waves
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This allows us to monitor and observe blood loss data in real time
Display: provides information on volume loss, rate, pulse, pO2, and BP with medications given.
Scale: to weigh the soiled drapes/sponges, because EDC!
Balloon Devices
Regardless of the type of balloon, they all share the same general principle of inserting a deflated balloon-type device through the cervix and into the cervical cavity. The balloon is then inflated to tamponade the bleeding. Below is some of the balloon devices being used around the world:
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Condom balloons: least expensive and generally most accessible globally. Constructed from commonly available medical supplies (condom, foley catheter)
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Bakri balloons: a silicone fluid-filled balloon designed specifically for tamponade. Can be filled with up to 500cc of sterile saline and can withstand a maximum internal and external pressure of 300mmHg.
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Ellavi balloon: designed for use in low-resource areas. Has a supply bag providing vertical filling pressure to the free flow pressure controlled uterine balloon. This allows the balloon pressure to be controlled by simply adjusting the height of the supply bag
Jada System
The Jada system is placed into the uterus where it creates a vacuum causing the uterus to collapse onto itself and the compression of bleeding vessels.
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Made of soft silicone and consists of an intrauterine loop with 20 interior vacuum pores to evacuate blood
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An expandable cervical seal is filled with a sterile fluid to create a vacuum seal within the uterus
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Is attached to a regulated vacuum source to collect excess blood
Butterfly Device
A small single piece plastic device used to mimic bimanual compression- a technique commonly used by health professionals to physically stop bleeding.
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The clinician inserts the device into the uterus and contains holes allowing for blood to drain through the surface
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Also allows for clinicians to view through the device to identify the source of bleeding while performing compressions
Body Suit
Body suits have seen use by the military and even NASA as a way to increase overall peripheral vascular resistance, halt bleeding, and splint fractures.
The same concept can be applied in the context of post-partum hemorrhage. By applying providing pressure to the woman's entire lower body via inflation of the suit, it can decrease bleeding in the context of PPH and redistribute blood to where it is needed (from the legs/feet to the heart/brain).
Cell Saver
Blood lost during a procedure can be 'salvaged' for autotransfusion (a process where an individual receives their own blood for a transfusion).
There are four key elements of cell saving + transfusion
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collection of blood
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addition of an anticoagulant
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processing, concentrating, and harvesting the red blood cells
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transfusion