QBL in the OR

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AdventHealth Zephryhills OR

Quantified Bloss Loss (QBL)

Postpartum hemorrahge remains the leading cause of maternal mortality in the United States. The Joint Comission and Assosication of Womens Health, Obstetric and Neonatal Nurses (AWHONN) recommends that culumative blood loss be objectively measured or quantified for every birth.

Why Quantify?

QBL Facts

Totals are added cumulatively

Quantified

Each 1 ml approximately equates to 1ml of blood loss

Measured

Every 1 g equals 1 ml of fluid

Weighed

Quantifying Blood Loss

• Digital Scale
• Basin - need to maintain stock
• Dry Weight cheat sheet

QBL Supplies

Supplies to measure QBL have been added to the OR:

Is QBL calculated in emergency c-sections?

What if the laps are wet?

Who Documents the QBL?

Should blood be calculated after the surgery has ended?

QBL q&a

Let's Practice

Lets Practice

Let's Practice

Let's Practice

Selelct the Link button fo complete the post survey for educational credit

Evaluation activity

Dry Weights are posted in the OR

1. Place a bucket on the scale.
2. Turn scale on and zero for calculation.
3. Weigh blood soaked items then
4. Subtract dry weight amounts

Yes, any blood on the under pad, floor, or patient blankets etc., should be weighed and added to the total QBL amount.

Other items to weigh

1. Pause at the time of delivery
2. Prompt delivery team to suction all the amniotic fluid
3. Note the amount in the suction canister or Neptune

Caluclating Volume in the Suction Canister or Neptune

Total measured weights+ total in suction canister- dry weights- amniotic fluid and irrigation used_______________= QBL

• Visual estimation increases the liklihood to underestimate blood loss leading to delays in response or denial.

• QBL promotes early identification of hemorrhage.

• QBL helps increase timely escalation of clinical care.

• QBL promotes increased team awareness.

• QBL contributes to earlier use of uterotonics and reduced need for blood transfusions.

The anesthesiaologist will document the QBL at the end of the case.

Documentation

Yes, QBL should be assessed in every delivery. Once the baby is delivered, the surgery can proceed at a normal pace and QBL can be calculated as usual.

QBL in Emergencies

Irrigation and fluid used will have to be accounted for and subtracted from the total QBL.

Wet Laps