Скачать или смотреть Bakri Balloon for Postpartum Hemorrhage

In managing postpartum hemorrhage that is not responding to medical resuscitation you may have to place a uterine tamponade device, such as a Bakri balloon. 

Equipment:
-Basin with sterile water or sterile saline, or an IV bag with 500 mL of saline or water
-Bakri balloon kit, which contains:
1. Bakri balloon
2. Tubing connecting to a one way valve
3. Stopcock
4. 50 mL syringe

Place the Bakri balloon into the uterus, either with ring forceps (no sharp objects) or with your hands. Placement can be confirmed with ultrasound if available. The operator (or assistant) will hold the device in place while being inflated to ensure it does not migrate.

Instill fluid into the Bakri balloon 50 mL at a time, up to an initial volume of 350 mL. This can either be done with the 3-way stopcock, or by using the one-way valve that comes in the kit. Do not instill air, as this may increase risk of air embolism.

Stop at 350 mL and check for residual bleeding. Connect a Foley catheter to the Bakri balloon to see if bleeding persists. If bleeding continues, proceed to inflate the Bakri balloon to a maximum volume of 500 mL.

Once the Bakri balloon is inflated and tamponade is achieved, place a Foley catheter in the bladder due to risk for iatrogenic urinary retention.

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