Estimating blood loss after birth: using simulated clinical examples.

AIM To determine the accuracy of the estimation of blood loss using simulated clinical examples. SETTING Over 100 attendees came together at a seminar about postpartum haemorrhage in June 2006. Five blood loss assessment stations were constructed, each containing a simulated clinical example. Each station was numbered and was made up of a variety of equipment used in birthing suites. Over 5L of 'artificial' blood was made. The artificial blood was similar to the colour and consistency of real blood. SAMPLE A convenience sample of 88 participants was given a response sheet and asked to estimate blood loss at each station. Participants included midwives, student midwives and an obstetrician. RESULTS Blood in a container (bedpan, kidney dish) was more accurately estimated than blood on sanitary pads, sheets or clothing. Lower volumes of blood were also estimated correctly by more participants than the higher volumes. DISCUSSION Improvements are still needed in visual estimation of blood loss following childbirth. Education programs may increase the level of accuracy. CONCLUSION We encourage other clinicians and educators to embark upon a similar exercise to assist midwives and others to improve their visual estimation of blood loss after birth. Accurate estimations can ensure that women who experience significant blood loss can receive appropriate care and the published rates of postpartum haemorrhage are correct.