Not just spotting: Hemorrhage control for the serious vaginal bleeder

Hemorrhage Control for Vaginal Bleeding

Vaginal Packing - Kerlex and sufficient lubrication

  • Kerlex can be coated with acetone of 5000 U Thrombin in 5 cc saline
  • Antibiotics prophylaxis for Toxic Shock Syndrome


  • Can attempt cervical os visualization to pass Foley or Bakri Balloon
  • Visualize cervix via speculum and grasp with ring forceps
  • Sterilize with Iodine
  • Pass Foley or Bakri Balloon and inflate

TXA (Transexamic Acid)

  • 10 mg/kg for max dose of 600 mg
  • Use caution in those prone to thromboembolic events

Always Remember your usual stuff

  • ABCs + IV/O2/Monitor + IVF
  • Transfuse O- blood +/- massive transfusion protocol
  • Reverse any anticoagulation/ bleeding disorders
  • OB/GYN consult!