Surveypoint

Q01

Vignette form no.

Q02

Name of interviewer

Q03

Place of Interview

Q04

Date

Q05

Designation

Q06

Age

Q07

Gender

Q08

Type of Facility

PHC

CHC

District Hospital

Private

A01

Did the doctor…

A01_1

..measure blood pressure?

Yes

No

A01_2

…measure pulse rate?

Yes

No

A01_3

…measure respiratory rate?

Yes

No

A01_4

…measure temperature or touch to check whether the skin feels cold/normal/warm to touch?

Yes

No

A01_5

…place the line and immediately start RL IV fluid

Yes

No

A01_6

…ask about history of prior PPH?

Yes

No

B01

Did the doctor…

B01_1

…ask if any medications were taken to speed up pregnancy (e.g., oxytocin)?

Yes

No

B01_2

… ask for latest hemoglobin reports prior to the delivery?

Yes

No

B01_3

… check whether it was prolonged or obstructed labor?

Yes

No

B01_4

…assess the amount of blood loss?

Yes

No

B01_5

….check with labour room regarding placenta delivery (whether complete or pieces were missing form placenta) and/ or check for any pieces of placenta manually?

Yes

No

B01_6

…check with labour room whether AMTSL (Active Management of Third Stage of Labor) was performed with 10 IU of oxytocin given intramuscularly on thigh?

Yes

No

B01_7

… ask for any existing illness or bleeding disorders?

Yes

No

B01_8

…conduct an overall exam (dehydrated, pale, conjunctival etc.)?

Yes

No

B01_9

…conduct external genitalia exam?

Yes

No

B01_10

…conduct cervical exam?

Yes

No

B01_11

…check the uterus for its tone?

Yes

No

C01

What is the diagnosis?

C02

If PPH is identified in previous point/question, ask- what is the type of PPH.

D01

Did the doctor…

D01_1

…ask for blood grouping and cross matching.

Yes

No

D01_2

…ask for hemoglobin

Yes

No

D01_3

…ask for coagulopathy labs

Yes

No

D01_4

…check with blood bank for the time of blood unit arrival.

Yes

No

D01_5

…start bimanual uterine massage

Yes

No

D01_6

…, gives IV Methergine to the patient or sublingual misoprostol 800 mcg

Yes

No

D01_7

… continue with ongoing Oxytocin through drip

Yes

No

D01_8

…check if uterus tonicity is returning?

Yes

No

E01

Did the doctor…

E01_1

… advise referral to the patient?

Yes

No

E01_2

… mention place of referral?

Yes

No

E01_3

…mention the name of the facility (s)he is referring the patient to?

Yes

No

E01_4

… mention the mode of referral?

Yes

No

E01_5

….. mention sending one health worker with the patient?

Yes

No

E01_6

….. mention sending additional IV infusion (RL) or crystalloid solutions?

Yes

No

E01_7

……inform the referring facility about the referral and condition of patient prior to referring?

Yes

No

F01

Did the doctor….

F01_1

…assess the general condition, check the vitals, and check if the IV lines are working, secure oxygen flow?

Yes

No

F01_2

…arrange for blood products (speak with blood bank etc)?

Yes

No

F01_3

…arrange for an obstetrician on duty to attend the patient?

Yes

No

F01_4

…arrange for anesthesia and prepare the OT?

Yes

No

F01_5

…arrange emergency medications- Tranexamic acid etc.?

Yes

No

F02

…. use any of these medical/surgical method for management of PPH?

F02_1

Blood transfusion

Yes

No

F02_2

Bimanual Compression of uterus

Yes

No

F02_3

Uterine tamponade using

Yes

No

F02_4

Check for coagulation defects.

Yes

No

F02_5

Surgical intervention

Yes

No

G01

Clinical Vignette Template 4 -Form Fill

Vignette form no.

Name of interviewer

Place of Interview

Date

Designation

Age

Gender

Type of Facility

Did the doctor… var statement=document.write(localStorage.getItem('total'));

..measure blood pressure?

…measure pulse rate?

…measure respiratory rate?

…measure temperature or touch to check whether the skin feels cold/normal/warm to touch?

…place the line and immediately start RL IV fluid

…ask about history of prior PPH?

Did the doctor… var statement=document.write(localStorage.getItem('total'));

…ask if any medications were taken to speed up pregnancy (e.g., oxytocin)?

… ask for latest hemoglobin reports prior to the delivery?

… check whether it was prolonged or obstructed labor?

…assess the amount of blood loss?

….check with labour room regarding placenta delivery (whether complete or pieces were missing form placenta) and/ or check for any pieces of placenta manually?

…check with labour room whether AMTSL (Active Management of Third Stage of Labor) was performed with 10 IU of oxytocin given intramuscularly on thigh?

… ask for any existing illness or bleeding disorders?

…conduct an overall exam (dehydrated, pale, conjunctival etc.)?

…conduct external genitalia exam?

…conduct cervical exam?

…check the uterus for its tone?

What is the diagnosis?

If PPH is identified in previous point/question, ask- what is the type of PPH.

Did the doctor… var statement=document.write(localStorage.getItem('total'));

…ask for blood grouping and cross matching.

…ask for hemoglobin

…ask for coagulopathy labs

…check with blood bank for the time of blood unit arrival.

…start bimanual uterine massage

…, gives IV Methergine to the patient or sublingual misoprostol 800 mcg

… continue with ongoing Oxytocin through drip

…check if uterus tonicity is returning?

Did the doctor… var statement=document.write(localStorage.getItem('total'));

… advise referral to the patient?

… mention place of referral?

…mention the name of the facility (s)he is referring the patient to?

… mention the mode of referral?

….. mention sending one health worker with the patient?

….. mention sending additional IV infusion (RL) or crystalloid solutions?

……inform the referring facility about the referral and condition of patient prior to referring?

Did the doctor…. var statement=document.write(localStorage.getItem('total'));

…assess the general condition, check the vitals, and check if the IV lines are working, secure oxygen flow?

…arrange for blood products (speak with blood bank etc)?

…arrange for an obstetrician on duty to attend the patient?

…arrange for anesthesia and prepare the OT?

…arrange emergency medications- Tranexamic acid etc.?

…. use any of these medical/surgical method for management of PPH? var statement=document.write(localStorage.getItem('total'));

Blood transfusion

Bimanual Compression of uterus

Uterine tamponade using

Check for coagulation defects.

Surgical intervention

Please elaborate what made you diagnose this as a case of (diagnosed condition). Why did you suggest this treatment?

Did the doctor…

Did the doctor…

Did the doctor…

Did the doctor…

Did the doctor….

…. use any of these medical/surgical method for management of PPH?