RED ALERT

Introduction

It’s a code for obstetric emergencies – a life threatening situation that can cause damage and death to mothers and babies. It
requires quick, decisive and effective action from the staff immediately available. It should be operational in all hospitals dealing with
obstetric cases where it helps improve emergency response time and reduces maternal morbidity and mortality.

How the Red Alert system functions

 Red Alert triggered in the presence of an emergency obstetric case in the Casualty Department or O&G Department
 The nurse or doctor in charge of the area activates the system by calling the telephone operator of the hospital and saying
‘Red Alert”
 The operator immediately initiate a “call system” to get the doctors involved to attend to this emergency – indicating
clearly the place
 Each hospital to establish its own system
 The doctors concerned will go to the area concerned

Indications

 Cord Prolapse
 Massive Ante Partum/ Post Partum Haemorrhage
 Uterine Inversion
 Shoulder Dystocia
 Eclampsia
 Maternal Shock

Team Members :

1) During Office Hours 2) After Office Hours

- O &G Consultant - Midwife

- Midwife - Staff Nurse

- Staff Nurse - Medical Officer On Call

- Unit Manager - Night Supervisor

- Paediatrician - Staff Nurse from other area

- Anesthetist - On call team (OT, lab technician)

- Blood bank / laboratory technician ( for APH/PPH)

- Rapid Response Team

- OT

- Pharmacist
 FLOWCHART ON HOW TO ACTIVATE RED ALERT CODE

*During office hours it will be the decision/order of O&G Consultant

1) During office hours

OB CONSULTANT

Identify the risk

Give order to activate Red Alert protocol

Provide treatment as needed

PRIMARY NURSE

Call for help. Activate Red Alert protocol and come back to assist OB Consultant

Safey measures should be taken prior activating the code e.g. side rails up

Continue monitoring vital signs, fetal heart rate (continuous CTG)

Administer O2 if indicated

Ensures IV access patent. Start resuscitation fluid as ordered

Performs all nursing interventions. Stay with patient all times. Documentation

Report to the team arrives. Info in clear and consice manner (SBAR)

1st RESPONDER

Get E trolley

Ready to assist anesthetist in intubation if needed

Blood taking, cannulation if need extra line (for PPH)

Assist with medication

UNIT MANAGER

Assign job to the staff. Direct other available personnel as needed

Support family

Call blood bank if urgent blood transfusion needed

2) After Office Hours

PRIMARY NURSE

Identify the risk

Call for help

Administer O2, monitor vital signs and FHR (continuous CTG). Maintain safety of patient, environment

Initiate CPR (maternal collapse)

Documentation

Report to team arrives

Cannulation , start fluid for resuscitation

1st RESPONDER

Activate code Red Alert

(RED ALERT, RED ALERT, RED ALERT!!!)

( LEVEL 5 LABOR ROOM 1 PPH)

Get E Cart, attach the leads

Assist in intubation if needed

Medication as ordered

MEDICAL OFFICER ON CALL

Assess patient and provide treatment and order as needed while waiting for arrival of Code Team

(medication,intubation)

Endorse to the main respective physician

Taking consent for possible EMLSCS (massive APH when labor not imminent)

ON CALL SUPERVISOR/MANAGER

Direct other available personnel as needed

Making arrangement with OT/blood bank if needed

Support family