Visual estimation of postpartum blood loss during a simulation training: A prospective study

Area of Science:

• Obstetrics and Gynecology
• Medical Simulation
• Patient Safety

Background:

• Postpartum hemorrhage remains a leading cause of maternal mortality worldwide.
• Accurate estimation of blood loss is critical for timely and effective management of postpartum hemorrhage.
• Visual estimation is commonly used but its accuracy in simulated scenarios is not well-defined.

Purpose of the Study:

• To compare visually estimated blood loss with actual volumes during postpartum hemorrhage simulation training.
• To evaluate the accuracy of visual estimation using both collector bags and absorbent pads.
• To identify factors influencing the accuracy of blood loss estimation in a simulated setting.

Main Methods:

• A simulation training study involving 137 participants was conducted.
• Participants visually estimated blood loss from graduated collector bags (600-1800mL) and absorbent pads (200-1000mL).
• Estimates were compared to the actual volumes in a simulated postpartum hemorrhage scenario.

Main Results:

• Visual estimates of blood loss were significantly different from actual volumes, except for absorbent pads with 400mL.
• Lower blood volumes were estimated more accurately with both collector bags and absorbent pads (p<0.001).
• Underestimation was common: 57% with collector bags and 51% with absorbent pads; 33% and 22% of estimates were accurate to ±50mL, respectively.

Conclusions:

• Simulation training effectively tests health professionals' visual blood loss estimation skills.
• Improving visual estimation accuracy is essential for enhancing maternal care during postpartum hemorrhage.
• Targeted training interventions may be necessary to improve the accuracy of blood loss estimation.