Opening Questions

How did the simulated experience of Amelia Sung's case make you feel?
 This simulation experience was very fun to do. I had previously watched a couple
of deliveries before during clinicals, but it was totally different actually doing this.

Describe the actions you felt went well in this scenario.

 The actions that went well in this scenario was taking the vitals, doing an
assessment, and providing care and comfort throughout the delivery process.

Scenario Analysis Questions*

EBP/I Discuss why shoulder dystocia is an obstetrical emergency.
 Shoulder dystocia is an obstetrical emergency because there can be many
dangerous complications that can affect mother and infant. There can be
postpartum hemorrhage, lacerations, brachial plexus palsy (on newborn), clavicle
fracture, fetal death, fetal hypoxia, and so many more dangerous things.

EBP Name one of the two distinct signs that indicate shoulder dystocia is present.
 A patient with a history of shoulder dystocia and excessive weight gain during the
pregnancy are at a greater risk for shoulder dystocia. Risk factors can include
maternal obesity, diabetes, preeclampsia, prolonged gestation, and even fetal
macrosomia.

EBP List potential problems for Amelia Sung and her baby related to the shoulder
dystocia.
 Morbidity/mortality
 Excessive bleeding or lacerations
 Possible fetal complications like nerve injury
 Fractured clavicles
 hypoxia

PCC/T&C What preventive measures were put in place related to Amelia Sung's history of
a previous shoulder dystocia?
 The charge nurse and NICU were informed about Sung’s case in case of emergency.
 Monitoring both mother and fetus and have everything ready if intervention is
necessary.
 Have the step stool (used to provide and apply suprapubic pressure directly over
the patient), and any other supplies in case of emergency

S/QI/I Consider what points might be included in a safety checklist for shoulder dystocia.
 Risk factors for shoulder dystocia
 Advance notice to charge nurse and to NICU, in order to intervene in case of
emergency
 Have step stool ready
 Educate patient of possible complications

Concluding Questions
Reflecting on Amelia Sung's case, were there any actions you would do differently? Explain.
Describe how you would apply the knowledge and skills that you obtained in Amelia Sung's
case to an actual patient care situation.
 I definitely did not do well the first time I did this simulation, but it was
because I did not know I had to set up the room and everything. I definitely
learned a lot from this simulation, and about should dystocia. I learned about
suprapubic pressure that helps to push the anterior shoulder under the pubic
bone and facilitate delivery.