Finding your way around the Obstetric Quick Reference Handbook (Obs QRH)

The Obs QRH has been designed to be as simple and clear as possible.

Cover section:  Easily identified in a crisis the cover section contains information designed to ensure the QRH is not taken away and is always returned safely to its storage point.

Contents page: Designed to enable users rapidly to locate a guideline within the QRH.

Instructions for use: A reminder of how to use the guidelines in a crisis.

Equipment page: A space to record the locations of key emergency equipment so they can be found in a crisis. The benefit of having this list on a single sheet is simplicity in implementation and to avoid having to make alterations or annotations to multiple guidelines.

The guidelines: These are separated into four sections:

Section 1: Obstetric Cardiac Arrest

Section 2: Maternal Collapse/Compromise

Section 3: Obstetric Emergencies

Section 4: Neonatal Emergencies

The following image demonstrates how the guidelines should be used:

1. Guidance number, name and version number.
2. A brief description of the clinical situation for which the guidance is written.
3. The body of the guidance.
4. Call out boxes, which may be referred to in the body text.

• Blue = drug doses
• Green = CPR information
• Black = equipment instructions
• Purple = other reference information
• Red = post-resuscitation / birth care
• Orange = *critical changes *Critical changes are not referred to in the body of the text

5. Guidance may suggest changing to one of the other action cards, like this: → 2-1.
6. The guidance number is repeated for easy finding without the need for a tabbed folder.

Each guidance should be used in the same simple way:

• Start at START.
• Work through the numbered bullet points in order.
• Where indicated, refer to the call out boxes on the right.
• Where indicated, move to another action card.

We recommend:

• Having a copy available in all clinical areas where birthing people are cared for.
• One person should read the guidance aloud; they should NOT be the person performing the actions.
• The reader should ensure that the guidance is followed systematically, thoroughly and completely and that steps are not omitted.
• Whenever experienced help arrives, consider delegating leadership to them; they have a fresh pair of eyes and may be able to make a more clear-headed assessment.