What immediate management steps should I take if a patient presents with signs of postpartum haemorrhage in the primary care setting?

If a patient presents with signs of postpartum haemorrhage in the primary care setting, the immediate management steps are critical and require prompt action:

• Call for immediate help ¹.
• Arrange for transfer of the woman to obstetric-led care ¹. This is crucial, especially if the patient is not already in an obstetric unit or if the placenta is retained ¹.
• If there are signs of shock, such as pallor, tachycardia, hypotension, or collapse, or if there is significant concern about the degree of bleeding or pain, arrange for immediate hospital admission, potentially directly to Accident and Emergency ⁵,⁶. Immediate resuscitation with intravenous fluids should be considered if available ⁵.
• While awaiting transfer and medical assistance, be aware that immediate clinical treatment involves emptying the bladder, uterine massage, administration of uterotonic drugs, and intravenous fluids ¹. Supplementary oxygen, starting at 15 L/minute via a non-rebreathing mask with a reservoir bag, should also be considered ¹.
• Continuously assess blood loss and the woman's condition to identify the source of the bleeding ¹.