A recent focus on the early identification of sepsis has reduced the number of women dying from this condition; yet midwives still need to be vigilant. Claire Axcell describes a recent experience
I palpate an oncoming contraction. ‘Your bump feels really warm,’ I say to the woman I'm caring for, ‘do you feel OK?’ She replies, shrugging: ‘Yes, I feel fine.’ All the observations were normal, the CTG fine and her labour progressing. However, every time I felt her stomach and palpated a contraction, I would find her stomach warm to the touch, radiating heat in a way that I haven't really felt before.
It therefore wasn't a surprise when later we were breaking out the sepsis box, taking blood cultures and, as the sepsis board in the staff room reminds us, swabbing everything. I spoke with my clinical lead about this, telling her of my experience and the modified early warning system (MEWS) chart, which didn't back up my feelings that something was not quite right. She said that there will be times like that, where you frown at a partogram or a CTG trace because something inside you says, ‘I'm not happy about this,’ but you can't quantify that feeling into a clinical issue.
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