All Bleeding Stops

The red climbs up the arm of my gown. It seeps under the glove, soaking the cuff.  

She just delivered, and she’s still bleeding.

No worries – I call for the PPH meds in the order I’ve memorized, used successfully hundreds of times before. 

It has always stopped before. 

I trust my training. 

She peers over the siderail toward her baby, trying to look past her partner and her nurse and the baby nurse and the pediatrician.  She’s been forgotten.  By all but her nurse and I.  

She’s trying to get a glimpse of the crying little baby she just worked for hours to deliver. 

She thinks the battle’s done. 

I know the real fight is just starting. 

I look at the placenta – looks like it’s all there. 

I look at the cervix – no lacerations. 

The blood keeps coming. 

The drill is exhausted. How soon can I repeat this med?

Activate mass transfusion protocol.  

Open the OR. 

“All bleeding stops.” “It’s not your blood.”  i.e., Keep your head in the game. Do the next step of the drill. 

But what happens when the drill has been exhausted and the bleeding is still audible?

The fear you see in the face of her partner before you leave the room for the OR.  His world rolling out the door in your care.

She’s white as a ghost, barely responsive.  

When you get to the OR, call for extra hands, and it’s not stopping – what next?

Please, Lord, let it stop. 

D&C, Bakri balloon, call interventional radiology, keep the blood coming.  

Do the next step.  

Until it stops.  

All bleeding stops.  

Eventually.