Introduction to PPH
Components
Inserting Ellavi
Monitoring & Management
Transport
Managing without a drip stand
Removal
C-Section Protocol
Patient preparation
At lowest Level of Care:
Insert and Refer (Insert the Ellavi UBT and refer to the next level of care)
Before the insertion of Ellavi UBT ensure the following:
- the uterus has been completely evacuated of all contents e.g. placenta, clots, etc
- ensure there is sterile saline/water nearby e.g. iv bag or bottled saline (at least 1L)
- exclude perineal, vaginal and cervical tears
Ellavi Preparation
1. ensure that the tap is closed; fill the supply bag with 1L of clean water or saline
Alternatively, spike a vaculitre of Saline or any other intravenous fluid with the cap.
2. connect the tubing to the supply bag by screwing on the cap and hanging the supply bag at 1.2m above the bed.
ellavi insertion
1. use your thumb to secure the deflated balloon in the palm of your hand
2. proceed to insert ellavi through the cervix until your fingers reach the thick upper segment of the uterus
3. use your free hand to gently advance the balloon deeper into the uterus (as high as possible)
4. gently remove your hand from he uterus and keep two fingers below the cervix
5. open the tap with your free hand (continue to keep two fingers below the cervix until the balloon is full – this prevents accidental expulsion of the balloon)
6. the balloon will fill in 45 seconds, after which you can remove your fingers from the vaginal canal
7. finally, secure the tubing to the patients upper leg , using tape, to prevent traction on the cervix
note: As the balloon inflates it will expel any accumulated blood from the uterus, but once the balloon has filled the entire uterus, bleeding should stop completely.