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

Tamponade

• 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!