Quality Improvement Reports

Clinical risk management in obstetrics: eclampsia drills

BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7434.269 (Published 29 January 2004) Cite this as: BMJ 2004;328:269

This article has a correction. Please see:

  1. Sarah Thompson, provisional fellow (sarahathompson{at}hotmail.com)1,
  2. Shona Neal, consultant anaesthetist2,
  3. Vicki Clark, consultant anaesthetist3
  1. 1Department of Anaesthetics, St George Hospital, Kograh 2217 Sydney, Australia
  2. 2St John's Hospital, Livingston, West Lothian EH54 6PP
  3. 3Royal Infirmary of Edinburgh, Edinburgh EH3 9YW
  1. Correspondence to: S Thompson
  • Accepted 18 November 2003


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.


  • Contributors ST has participated in and coordinates drills, and initiated this article. SN is the lead obstetric anaesthetist in a district hospital, coordinates drills in her unit, and provided the photograph. VC initiated and organises the obstetric emergency drills programme at the Simpson Centre for Reproductive Health, Royal Infirmary of Edinburgh.

  • Funding None declared.

  • Competing interests None declared.

  • Accepted 18 November 2003
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