Eclampsia checklist.

1. Eclampsia Checklist
Call for help Initial actions Treat
STEP 3: TREAT
□ 2 wide-bore IVs (16-18g) □ Vitals q1-2 min □ Monitor FHT
□ Administer seizure prophylaxis:
□ Administer seizure treatment:
□ Administer anti-hypertensive medication (if required):
MEDICATION LABETALOL HYDRALAZINE NIFEDIPINE
Initial dose Labetalol 20 mg IV bolus Hydralazine 5-10 mg IV bolus Nifedipine 10 mg PO
→ Recheck BP
If BP remains
elevated
After 10 min; labetalol 40 mg IV
bolus
After 10 min; labetalol 80 mg IV
bolus
After 10 min; hydralazine 10 mg
IV bolus
After 20 min; hydralazine 10 mg IV
bolus
After 20 min; labetalol 20 mg IV
bolus
After 10 min; labetalol 40 mg IV
bolus
After 20 min; nifedipine 20 mg
PO
After 20 min; nifedipine 20 mg
PO
After 20 min; labetalol 20 mg IV
bolus
→ Consult: MFM/Anesthesia/ICU/Internal medicine
STEP 1: CALL FOR HELP!
□ OB Rapid Response
□ Assign nursing roles
STEP 2: PROTECT AIRWAY
□ Turn patient to side
□ Support airway (BLS) + suction available
□ 100% oxygen via nonrebreather face mask
During or post-seizure:
If not on magnesium sulfate, administer 4-6 g IV bolus (over 20 min)
If already on magnesium sulfate, administer 2 g IV bolus (over 3-5 min)
Maintenance dose = 1-2 g/h IV infusion
Non-terminating seizure:
Administer midazolam 2 mg IV bolus (or lorazepam 4 mg IV bolus)
Anesthesiologists: consider propofol 20-40 mg IV bolus
If seizure continues, consider modified rapid sequence induction + intubation
1) Emergent therapy for acute-onset, severe hypertension during pregnancy and the postpartum period. ACOG Committee Opinion No. 767. American College of Obstetricians and Gynecologists.
Obstet Gynecol 2019;133:e174-80
2) Preeclampsia Toolkit: Improving Health Care Response to Preeclampsia (California Maternal Quality Care Collaborative Toolkit to Transform Maternity Care). 2014