Showing posts tagged with: 'CEMACH'


MEOWS: Recommended

Sat 25th Apr 2009 by Ben Palmer.

I spend a lot of time campaigning for the national use of Modified Obstetric Early Warning System (MEOWS) chart, and indeed I was in Oxford yesterday talking to some midwifery students about their use, and the difference they would almost certainly have made to Jessica.

Not everybody always immediately shares my enthusiasm for them. I've been challenged more than once. It has even been suggested to me that the NHS isn't ready for them. Tosh. In December 2007 I learnt that an estimated 10% of NHS Trusts were using them, and that figure is increasing as MEOWS is adopted Trust by Trust, even if only for high risk mothers. What is a high risk mother? Jessica wasn't but she died. Every mother should be followed for the first 10 days after delivery by her own MEOWS chart, I believe.

As for being a lone voice - this is what the Confidential Enquiry into Maternal and Child Health (CEMACH) said in it's top 10 recommendations to save mothers' lives in it's 2007 report, using prevention of deaths from sepsis as an example:

Early warning scoring system

9. There is an urgent need for the routine use of a national obstetric early warning chart, similar to those in use in other areas of clinical practice, which can be used for all obstetric women which will help in the more timely recognition, treatment and referral of women who have, or are developing, a critical illness. In the meantime all trusts should adopt one of the existing modified early obstetric warning scoring systems of the type described in the Chapter on Critical Care, which will help in the more timely recognition of woman who have, or are developing, a critical illness. It is important these charts are also used for pregnant women being cared for outside the obstetric setting for example in gynaecology, Emergency Departments and in Critical Care.

Rationale

In many cases in this Report, the early warning signs of impending maternal collapse went unrecognised. The early detection of severe illness in mothers remains a challenge to all involved in their care. The relative rarity of such events combined with the normal changes in physiology associated with pregnancy and childbirth compounds the problem. Modified early warning scoring systems have been successfully introduced into other areas of clinical practice and a system which has been modified for obstetric mothers is discussed in Chapter 19, together with an example of such a chart. These should be introduced for all obstetric admissions in all clinical settings.

In developing this recommendation, a consultant from a hospital where staff are trying to get such a scheme introduced said “we have had three near misses related to unrecognised sepsis in the last two months, all of which would have been picked up by this chart. All three women came close to featuring in the next edition of your Report”.

Auditable standards

  • A National Modified Obstetric Early Warning System (MEOWS) chart developed and piloting started by December 2008.
  • In the interim, the number of trusts who have adopted a version of any existing MEOWS charts and trained all staff in its use by the end of 2008

Lewis, G (ed) 2007. The Confidential Enquiry into Maternal and Child Health (CEMACH). Saving Mothers’ Lives: reviewing maternal deaths to make motherhood safer - 2003-2005. The Seventh Report on Confidential Enquiries into Maternal Deaths in the United Kingdom. London: CEMACH.

Update: The report link has moved to the new CMACE website

tags:

1 Comment »  |  Trackback  |   Subscribe to RSS    Subscribe by Email   

Don't miss the bear

Wed 11th Feb 2009 by Ben Palmer.

When I spoke in Basingstoke, at the SE Regional conference a little while ago, one of the highlights was this video, shown by one of the other speakers.

Concentrate hard and follow the instructions.

When we watched it there was a big cheer as everyone got the correct answer, and then a gasp!

I had a letter today, from CEMACH, with some of the comments made by the (mainly midwife) delegates at the South East Regional CEMACH conference in Basingstoke Jan 2009, in their evaluation forms. To underline the purpose of Jessica's Trust, the campaign and our petition, I thought I'd share a few:

  • Jessica's story highlighted the need for MEOWS on the postnatal wards
  • Jessica's story of tragedy shows the importance of how not to miss the bear moon-walking amidst the data.
  • High quality communication, referral & follow ups is vital to good provision of care - information should be provided to all women in a way that they can understand it + make choices about their care. - I will always remember Jessica's story.
  • Importance of observation! To re-emphasis use of MEOWS.
  • Higher awareness in units regarding newly introduced MEOWS.
  • Considering how to take forward Ben's message in practice.
  • Copy of MEOWS chart of postnatal women's observations to community midwives.
  • Jessica's story increasingly moving.
  • The presentation from Ben was extremely poignant and completely sums up the purpose of CEMACH - Very powerful and real life experience should be portrayed to many more maternity staff - it keeps the reality in the midst of statistics and risk.
  • There is a need for an early warning system to be implemented in trusts. We need to ensure that women are aware of risks & that there are guidelines for e.g. sepsis in pregnancy.

Thank you to CEMACH for inviting me to speak, and for permission to use these comments.

[It has to be said, it's more of a surprise if the video isn't titled before you watch it!]

tags:

Comments Off on Don't miss the bear  |  Trackback  |   Subscribe to RSS    Subscribe by Email   



What is childbed fever?

Childbed fever is an infection of the womb in new mothers which can lead to septicaemia. If left untreated infection will cause organ failure and death - even in young, fit mothers.
more»
What are the symptoms? »
Childbed fever: the facts »

What's the aim?

We would like every parent and every midwife and doctor to know that childbed fever is still a very real threat to a mother's life.
more »
Can I help? »

Who is Jessica?

Jessica Palmer was a Mum. She died in June 2004, at 34 years old, of childbed fever caused by Group A streptococcus.
more »

This website contains general information about childbed fever. The information is not complete or comprehensive. You should not rely on the information on this website as an alternative to medical advice from your doctor or healthcare provider. If you have any specific questions about childbed fever (or any other medical condition) you should consult your doctor or other healthcare provider; and if you think you may be suffering from childbed fever (or any other medical condition) you should seek immediately medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.
variform
variform