Write the weight, the dose per kilogram, and the volumeEvery single time
| Uterotonic | Dose | Do not give if | Watch for |
|---|
| Oxytocin | 10 to 40 units in 500 to 1000 mL isotonic IV; or 10 units IM | Never as an undiluted IV push | Hypotension, tachycardia, water intoxication |
| Methylergonovine | 0.2 mg IM every 2 to 4 hours | Hypertension, preeclampsia, cardiac disease | Check BP before every dose; headache, chest pain |
| Carboprost | 250 micrograms IM every 15 to 90 min, max 8 doses (2 mg) | Asthma | Diarrhoea, vomiting, fever, bronchospasm |
| Misoprostol | 600 to 1000 micrograms oral, sublingual or rectal | Known prostaglandin allergy | Fever, shivering |
| Tranexamic acid | 1 g IV over 10 min, within 3 hours of birth | Active thromboembolic disease | Repeat once after 30 min if bleeding persists |
Never give a calculated result that exceeds the maximum recommended dose for that drug — the arithmetic being right does not make the dose safe.
Choose an emergencyThen act, one decision at a time
The sequence is the treatmentPick an emergency on the left, then choose your actions in the order you believe is right. The patient will respond honestly.
When you escalate, lead with the ask. “S — Dr Okafor, this is Sam, RN, in Room 4. Ms Alvarez is 39 weeks, para 1, on oxytocin, and I have a category III tracing. B — She is 7 cm, membranes ruptured 20 minutes ago, and she had recurrent late decelerations before this. A — Baseline 90 for the last 4 minutes with absent variability. I have turned her left side, stopped the oxytocin, bolused a litre, and examined her — no prolapse. R — I need you at the bedside now and I am opening the caesarean tray.”