- Be several egnaged people

At Namsos Hospital Helse Nord-Trøndelag HF, external aortic compression has been introduced in the management of postpartum haemorrhage – with good results. Anaesthesia nurse Trude Falch has been a driving force behind the training and shares her experience with ExAC: -We are a small hospital with a maternity ward, and we have on several occasions had women arrive for revisio uteri almost exsanguinated and critically ill. Such events are resource-intensive for all departments involved, says Falch.

She took the initiative to introduce external aortic compression into the hospital's daily routines and procedures, in order to buy valuable time in critical situations and reduce resource use in the longer term.

The training was built up systematically: theoretical teaching followed by practical training out in the departments, with exercises on the ExAC Trainer (www.exac.no/exactrainer). Anaesthesia staff, OR nurses, gynaecologists, midwives, paediatric nurses and assistants have all received training, and the method has also been introduced to the intensive care unit and the emergency department.

The effort has produced results in practice:

— We have used external aortic compression on two occasions, both times with a successful outcome: reduced bleeding, better overview, and intervention in the operating theatre avoided, says Falch.

Experience from Namsos shows that systematic training lowers the threshold for actually applying the technique when the need arises – and that a good first-time experience builds a positive reputation and trust among staff.

At the same time, Falch is clear that implementation requires organisational buy-in:

— It requires someone to organise and keep things in order, and you need to team up with other engaged people who have some influence. My advice is: be several engaged people, and set aside plenty of time. Even if everyone agrees it's a good idea, the implementation still needs to be well organised to succeed.

Namsos Hospital shows how external aortic compression can give a small hospital an additional, effective tool in acute bleeding situations – good training and someone taking responsibility are key success factors!