Pattern and degree of forces applied during simulation of shoulder dystocia - 22/08/11
, Denise Ellis, RM a, Mark James, MD b, Linda P. Hunt, PhD c, Robert Fox, MB d, Timothy J. Draycott, MD a
Reprints: Dr Joanna Crofts, Research Fellow, Department of Obstetrics and Gynaecology, North Bristol NHS Trust, Southmead Hospital, Bristol BS10 5NB, UK.Résumé |
Objective |
The objective of the study was to determine the level and pattern of forces applied during simulated shoulder dystocia.
Study Design |
One hundred forty staff (95 midwives, 45 obstetricians) were randomized from 6 UK hospitals. Applied delivery force was measured during a standardized simulated shoulder dystocia. Maximum, average, total, and applied force gradients were calculated for each delivery.
Results |
There was a wide range for all force variables: geometric mean maximum applied force 106 newtons (N) (range 6 to more than 250, n = 113), maximum force gradient 45 N/s (range 2-249, n = 113), total applied force 2954 N/s (range 33 to 14,197, n = 108), and average applied force 16 N (range 0-68, n = 108).
Conclusions |
Despite participants managing the same scenario, there was great variation in the pattern and degree of traction used. High forces were applied during two thirds of simulations. Training must emphasize that maneuvers should be used to overcome shoulder dystocia while minimizing iatrogenic applied force.
Le texte complet de cet article est disponible en PDF.Key words : brachial plexus injury, force, shoulder dystocia, simulation
Plan
| This study was part of the SaFE Study (Simulation and Fire-Drill Evaluation), which was funded by the Patient Safety Research Programme of the Department of Health of England and Wales. The study was conducted in: Cheltenham, Gloucestershire, UK; Gloucester, Gloucestershire, UK; Bristol, Bristol, UK; Taunton, Somerset, UK; Exeter, Devon, UK; and Truro, Cornwall, UK |
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| Cite this article as: Crofts JF, Ellis D, James M, et al. Pattern and degree of forces applied during simulation of shoulder dystocia. Am J Obstet Gynecol 2007;197:156.e1-156.e6. |
Vol 197 - N° 2
P. 156.e1-156.e6 - août 2007 Retour au numéro
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