Risk Management & Mitigation Flashcards
7 cards from real ABOG practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Risk Management & Mitigation flashcards as text
A patient undergoing cesarean delivery develops uncontrolled hemorrhage from a placenta accreta spectrum. Which stepwise surgical intervention is most appropriate BEFORE proceeding to hysterectomy?
Answer: Uterine compression sutures and bilateral uterine artery ligation
Uterine compression sutures (e.g., B-Lynch) combined with uterine artery ligation represent recommended conservative surgical steps before hysterectomy in refractory postpartum hemorrhage.
Which documentation practice best reduces medicolegal risk when a patient declines recommended fetal monitoring during labor?
Answer: Document the refusal, risks discussed, and patient's understanding in the medical record
Thorough documentation of informed refusal—including risks explained and patient's demonstrated understanding—creates a defensible medical record.
A patient at 34 weeks gestation with suspected sepsis has a lactate of 4.2 mmol/L. What is the most critical immediate intervention per Surviving Sepsis guidelines?
Answer: IV fluid resuscitation with 30 mL/kg crystalloid and broad-spectrum IV antibiotics within 1 hour
Sepsis-3 bundle requires prompt IV fluid resuscitation and broad-spectrum antibiotics within 1 hour when lactate ≥2 mmol/L, signaling tissue hypoperfusion.
Which action most effectively reduces wrong-site or wrong-patient surgical errors in obstetric and gynecologic procedures?
Answer: Completing a formal surgical time-out with all team members present before incision
The Universal Protocol requires a pre-incision time-out involving all team members to verify patient identity, procedure, and site, reducing never events.
A postoperative hysterectomy patient develops fever, tachycardia, and purulent wound discharge on day 4. Which risk management step is most important after initiating treatment?
Answer: Notify the hospital risk management team and complete an incident report
Adverse events require timely incident reporting to risk management to facilitate investigation, quality improvement, and appropriate patient communication.
When is it most appropriate to invoke an emergency cesarean delivery protocol (Category I fetal heart rate tracing) in a risk management framework?
Answer: When the FHR tracing shows persistent bradycardia or prolonged decelerations unresponsive to resuscitative measures
Category I emergency cesarean is indicated for nonreassuring FHR patterns unresponsive to intrauterine resuscitation, where delay risks fetal compromise.
Which strategy most reduces the risk of retained surgical items (RSIs) during gynecologic laparotomy?
Answer: Implement standardized surgical counts (opening, closing, and final) with adjunct technology such as radiofrequency detection
Standardized counting protocols combined with radiofrequency or bar-code adjunct technology are evidence-based strategies to prevent retained surgical items.