BMJ  2004;328:269-271 (31 January), doi:10.1136/bmj.328.7434.269

Quality improvement report

Clinical risk management in obstetrics: eclampsia drills

¹ Department of Anaesthetics, St George Hospital, Kograh 2217 Sydney, Australia, ² St John's Hospital, Livingston, West Lothian EH54 6PP, ³ Royal Infirmary of Edinburgh, Edinburgh EH3 9YW

Problem Infrequent presentation of patients with eclampsia, leading to staff inexperienced in the condition and untested emergency systems.

Design "Fire drill" programme using on-site simulation of patients with eclampsia.

Setting Tertiary referral obstetric unit.

Key measures for improvement Successful implementation of measures to optimise management of eclampsia.

Strategies for change Rapid activation of emergency team after one call, development and dissemination of evidence based protocol for eclampsia, strategically placed "eclampsia boxes," individual staff feedback and education.

Effects of change Efficient and appropriate management of subsequent simulated patients.

Lessons learnt On-site simulation can identify and correct potential deficiencies in the care of patients with eclampsia.

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This article has been cited by other articles:

• Okafor, U V, Efetie, R E (2008). Critical care management of eclamptics: challenges in an African setting. Trop Doct 38: 11-13 [Abstract] [Full text]  
• Mateos Rodriguez, A. A, Vellisca, M. A. B. (2007). Management of eclampsia in the prehospital setting. Emerg. Med. J. 24: 504-504 [Abstract] [Full text]  
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