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unanticipated, unpredictable nightmare of the obstetrician. (Langer et al,1991). INCIDENCE. 0.2-2%.

This refers to activating the pre-arranged protocol or requesting the appropriate personnel to respond with E . Episiotomy should be considered throughout the management of shoulder dystocia but is necessary only to make more L . The HELPERR mnemonic is a clinical tool that offers a structured framework for coping with shoulder dystocia .25 These maneuvers are designed to do one of three things: increase the functional Shoulder dystocia is a rare obstetric emergency which can be managed using the HELPERR mnemonic. Midwives should recognise the signs and understand the principles of managing shoulder dystocia. Step-by-step images to illustrate the HELPERR mnemonic can enhance knowledge and understanding of this logical sequence of actions.

Review the HELPERR. Mnemonic. Equipment ready. Forceps ready.

An episiotomy is an incision or cut in the perineum between your anus and Shoulder dystocia is a rare obstetric emergency which can be managed using the HELPERR mnemonic. Midwives should recognise the signs and understand the principles of managing shoulder dystocia. The management of shoulder dystocia has been made safer and more controlled by using a mnemonic to describe an evidence-based pathway. It has facilitated a multi-disciplinary team-based approach R Roll on all fours (Gaskin position) - may relieve up to 83% of shoulder dystocia; ALARMER mnemonic is an alternative to the HELPERR mnemonic and provides a slightly altered sequence of interventions: A Ask for help; L Legs to chest (McRoberts maneuver) A Anterior shoulder disimpaction by suprapubic pressure The literature encourages a structured and systematic approach to alleviating shoulder dystocia by using the HELPERR mnemonic (Advanced Life Support in Obstetrics (ALSO), 2000, Baxley and Gobbo, 2004; RCOG, 2005) and the manoeuvre which had been evaluated as being the most effective – the ‘roll’ (Bruner et al., 1999) – is the last to be implemented when following the mnemonic. Shoulder Dystocia (HELPER AB) Page 1 of 2 M Brinsmead June 2011 SHOULDER DYSTOCIA = HELPER AB H Send for Help El Elevate the legs (McRoberts Manoeuvre) P SupraPubic Pressure E Episiotomy R Rotate the shoulders A Bring down the posterior Arm B Beware/Be prepared for Bleeding PPH H is for Help Get extra help 8.

Shoulder dystocia typically occurs when the anterior shoulder impacts on the pubic symphysis, less often when posterior shoulder impacts on the sacral promontory. Risk factors include abnormal maternal pelvic anatomy, gestational diabetes, post-dates pregnancy, previous shoulder dystocia, short maternal stature, and fetal macrosomia. The ALARMER mnemonic is recommended as a standard approach when a shoulder dystocia is diagnosed (SOGC, ALARM; MOREOB, 2010).
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Alarmer mnemonic is an alternative to the helperr mnemonic and provides a slightly altered sequence of interventions. Alarmer acronym for actions to address shoulder dystocia the land afrom alarmer illustration by alison martin ask 7.5 Shoulder dystocia Delivery cannot progress after the head is out, because the shoulders are impacted in the pelvis. This is a life-threatening emergency for the foetus (distress, rapid death by asphyxiation). Risk of recurrent shoulder dystocia in the next pregnancy 1-13%.

The HELPERR mnemonic H Call for help E Evaluate for episiotomy L Legs (the McRoberts' manoeuvre) P Suprapubic pressure E Enter maneuvers (internal (2008) noted that in the past, the diagnosis of shoulder dystocia only relied on the birth episiotomy. The pneumonic HELPERR is widely used and understood. 10 Jun 2015 Impaction of the fetal anterior shoulder behind the maternal pubic symphysis. This disorder prevents progression of delivery. Read More.
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Those promoted are the HELPERR mnemonic and PALE SISTER. This is also known as the Mazzanti maneuver--dystocia is just crawling with eponyms. If unsuccessful, try rotational maneuvers like the famous Woods' Screw, aka the Rubin Technique. Essentially you'll want to place a finger into the vagina, anterior to the infant's posterior shoulder. Then rotate 180 degrees, like a big old screw in the wall. Doses of Meds for PPH due to Atony. 1) Oxytocin/Syntocinon - 10U IV or IM. 10-40U in 1L NS @ 250cc/h.

Step-by-step images to illustrate the HELPERR mnemonic can enhance knowledge and understanding of this logical sequence of actions. About Press Copyright Contact us Creators Advertise Developers Terms Privacy Policy & Safety How YouTube works Test new features Press Copyright Contact us Creators The HELPERR mnemonic is a clinical tool that offers a structured framework for cop-ing with shoulder dystocia (Table 3).25 These maneuvers are designed to do one of three Does the HELPERR Mnemonic Really Help? Call for Help. This first response might seem like the only one necessary. But to many medical professionals, asking for heal is a sign of weakness. Evaluate for Episiotomy.
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Then rotate 180 degrees, like a big old screw in the wall. Doses of Meds for PPH due to Atony. 1) Oxytocin/Syntocinon - 10U IV or IM. 10-40U in 1L NS @ 250cc/h. 2) Methylergonovine 0.2mg IM or Ergometrine 0.5mg IM. 3) Prostaglandin F2alpha 0.25mg IM or intramyometrial (repeat q15 min up to 8 doses but consider surgery after 2 doses) Management of shoulder dystocia using the HELPERR mnemonic.