-VISIT OUR OTHER FORUMS- OB-GYN-L Ultrasound Ultrasound History Fibroid Forum Physicians-in-Training Tech Talk OBSTET-L (portuguese) OBGIN-L (spanish) Nursing

Re: Shoulder dystocia - Again! From: Anna Meenan, MD (annam@uic.edu) Sun Sep 19 21:04:08 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Anna Meenan, MD: "Re: Shoulder dystocia - Again!" Previous message: Vicki Smith: "Re: Shoulder dystocia - Again!" In reply to: Vicki Smith: "Re: Shoulder dystocia - Again!" Next in thread: Steve & Eryl Raymond: "Re: Shoulder dystocia - Again!" >From the shoulder dystocia workshop in the AAFP's (Am. Acad. of Family Practice) ALSO course (Advanced Life Support in Obstetrics). H--Help--call for Help--activate institutional protocol if you have one E--Evaluate for episiotomy (doesn't mean you have to do one if you decide that the perineal soft tissue is not holding things up) Legs--McRobert's Maneuver Pressure--Suprapubic pressure by an assistant, directed from behind the anterior shoulder E--Enter--hand enters the vagina to attempt rotational maneuvers (Rubin's, Wood's screw) R--Roll--roll the patient to hands and knees--AKA the Gaskin Maneuver R--Remove the posterior arm The last two started out in the opposite order but were switched a couple of years ago. Actually, in the workshop we emphasize that the maneuvers need not be done in exactly that order, but that it IS important to stick to recognized maneuvers and avoid panic and desperate pulling on the head or resorting to fundal pressure. We have started seeing more midwives at our ALSO course, and even some L&D nurses. The courses are offered all over the country, several times a year. It's an excellent two-day summary of common obstetrical emergencies. Opportunity for hands-on practice in the workshops. If you're interested in taking a course, look in any issue of the American Family Physician journal in the CME Calender section, or contact the AAFP through their website (http://www.aafp.org). I reviewed an Erb's palsey case once for a doc who documented HELPERR maneuvers in her delivery note and testified in her dep. that she routinely reviewed the HELPERR mnemonic in the ALSO manual they keep on L&D at her hospital before any high-risk delivery. I testified that she was obviously a very careful and conscientious doc. The case was dropped. -- Anna Meenan, MD, FAAFP At Sun, 19 Sep 2004, Vicki Smith wrote: > >Excuse my ignorance- but I am a CNM- What is the HELPERR mnemonic? > >-- >Vicki Smith >dellview@earthlink.net >Midwives- Changing the world one baby at a time. > Next message: Anna Meenan, MD: "Re: Shoulder dystocia - Again!" Previous message: Vicki Smith: "Re: Shoulder dystocia - Again!" In reply to: Vicki Smith: "Re: Shoulder dystocia - Again!" Next in thread: Steve & Eryl Raymond: "Re: Shoulder dystocia - Again!"

Return to

Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Wed Dec 2 04:57:44 2009

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.