堂 RAPID ASSESSMENT AND MANAGEMENT(RAM) Use this chart for rapid assessment and management(RAM)of all women of childbearing age,and also for women in labour,on first arrival and periodically throughout labour,delivery and the postpartum period.Assess for all emergency and priority signs and give appropriate treatments,then refer the woman to hospital.- FIRSTASSESS EMERGENCY SIGNS MEASURE TREATMENT Do all emergency steps before referral N3WOM AIRWAY AND BREATHING Very difficult breathing or Manage airway and breathing Es This may be pneumonia,severe ■Central cyanosis Refer woman urgently to hospital* anaemia with heart failure. 告 obstructed breathing,asthma. CIRCULATION(SHOCK)） If systolic BP<90 mmHg or pulse >110 per minute: ■Cold moist skin or This may be haemorrhagic shock Measure blood pressure Position the woman on her left side with legs higher than chest. septic shock. ■Neak and fast pulse ■Count pulse ■Insert an IV line BS ■Give fluids rapidlyB If not able to insert peripheral IV,use alterativeE Keep her wamm(cover her). Refer her urgently to hospital*E But if birth is imminent(bulging.thin perineum during contractions,visible fetal head),transfer woman to labour room and proceed as on D2. NEXT:Vaginal bleeding Rapid assessment and management (RAM)Airway and breathing,circulation(shock) B3Rapid assessment and management (RAM) Airway and breathing, circulation (shock) NEXT: Vaginal bleeding QUICK CHECK, RAPID ASSESSMENT AND MANAGEMENT OF WOMEN OF CHILDBEARING AGE B3 This may be pneumonia, severe anaemia with heart failure, obstructed breathing, asthma. This may be haemorrhagic shock, septic shock. TREATMENT N Manage airway and breathing B9 . N Refer woman urgently to hospital* B17 . If systolic BP < 90 mmHg or pulse >110 per minute: N Position the woman on her left side with legs higher than chest. N Insert an IV line B9 . N Give fluids rapidly B9 . N If not able to insert peripheral IV, use alternative B9 . N Keep her warm (cover her). N Refer her urgently to hospital* B17 . * But if birth is imminent (bulging, thin perineum during contractions, visible fetal head), transfer woman to labour room and proceed as on D1-D28 . RAPID ASSESSMENT AND MANAGEMENT (RAM) Use this chart for rapid assessment and management (RAM) of all women of childbearing age, and also for women in labour, on first arrival and periodically throughout labour, delivery and the postpartum period. Assess for all emergency and priority signs and give appropriate treatments, then refer the woman to hospital.- FIRST ASSESS EMERGENCY SIGNS Do all emergency steps before referral AIRWAY AND BREATHING N Very difficult breathing or N Central cyanosis CIRCULATION (SHOCK) N Cold moist skin or N Weak and fast pulse MEASURE N Measure blood pressure N Count pulse T