A 21-year-old primiparous patient had a normal vaginal delivery 48 hours ago. The midwife who visited her today was concerned and sent the patient to hospital.

Her observations are:

  • Respiratory rate 28/min
  • Heart rate 110 bpm
  • BP 98/60 mmHg
  • She had foul smelling lochia
  • Temperature 38.4°C
  • She looks unwell

Look at the MEOWS chart for this patient (Fig 1) and summarize the observations in your summary table.

Question 1: Does your summary table look like this?

Answer

Zoom
Fig 1 MEOWS chart for case study 2

A 21-year-old primiparous patient had a normal vaginal delivery 48 hours ago. The midwife who visited her today was concerned and sent the patient to hospital.

Her observations are:

  • Respiratory rate 28/min
  • Heart rate 110 bpm
  • BP 98/60 mmHg
  • She had foul smelling lochia
  • Temperature 38.4°C
  • She looks unwell

Look at the MEOWS chart for this patient (Fig 1) and summarize the observations in your summary table.

Question 1: Does your summary table look like this?

Question 2: Is this patient sick?

Answer

Answer 1: The MEOWS for this patient is:

White Yellow Red
Respiration 28/min
Heart rate 110 bpm
Blood pressure 85/50 mmHg
Looks unwell Yes
Temperature 38.4°C
Lochia Offensive
Total

Answer 2: This patient is very sick and needs to be seen urgently.

A 21-year-old primiparous patient had a normal vaginal delivery 48 hours ago. The midwife who visited her today was concerned and sent the patient to hospital.

Her observations are:

  • Respiratory rate 28/min
  • Heart rate 110 bpm
  • BP 98/60 mmHg
  • She had foul smelling lochia
  • Temperature 38.4°C
  • She looks unwell

Look at the MEOWS chart for this patient (Fig 1) and summarize the observations in your summary table.

Question 1: Does your summary table look like this?

Question 2: Is this patient sick?

Question 3: What do you think is going on?

Answer

Answer 1: The MEOWS for this patient is:

White Yellow Red
Respiration 28/min
Heart rate 110 bpm
Blood pressure 85/50 mmHg
Looks unwell Yes
Temperature 38.4°C
Lochia Offensive
Total 5 1

Answer 2: This patient is very sick and needs to be seen urgently.

A 21-year-old primiparous patient had a normal vaginal delivery 48 hours ago. The midwife who visited her today was concerned and sent the patient to hospital.

Her observations are:

  • Respiratory rate 28/min
  • Heart rate 110 bpm
  • BP 98/60 mmHg
  • She had foul smelling lochia
  • Temperature 38.4°C
  • She looks unwell

Look at the MEOWS chart for this patient (Fig 1) and summarize the observations in your summary table.

Question 1: Does your summary table look like this?

Question 2: Is this patient sick?

Question 3: What do you think is going on?

Answer 1: The MEOWS for this patient is:

White Yellow Red
Respiration 28/min
Heart rate 110 bpm
Blood pressure 85/50 mmHg
Looks unwell Yes
Temperature 38.4°C
Lochia Offensive
Total 5 1

Answer 2: This patient is very sick and needs to be seen urgently.

Answer 3: She is unwell with a high respiratory rate, heart rate, temperature and low blood pressure.

Diagnosis: Sepsis

Sepsis 6 bundle to be done within one hour:

  1. Give oxygen
  2. Get blood culture, urine culture, vaginal and throat swab
  3. Start IV fluids
  4. Start IV antibiotics
  5. Measure lactate
  6. Measure urine output

May need HDU/ITU Care.