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EFM Case Study #11: Decelerations-Does depth-duration-frequency matter? (1 hour Monograph)

Hours: 1.00

Best suited for: Obstetricians and family practice physicians. Midwives, obstetric nurse practitioners, residents and other interested healthcare practitioners skilled in EFM and EFM stakeholders are also welcome to participate.

 Electronic fetal monitoring interpretation is a major factor in obstetric malpractice allegations. When interpreting FHR patterns, the presence of decelerations (late, variable, or prolonged) is an abnormal finding. Determining when to intervene once decelerations are observed is difficult. Current NICHD guidelines and ACOG management algorithms do not include a deceleration severity scale. This is considered a major limitation by some clinical experts and increases risk of fetal injury and malpractice claims. Perinatal practitioners need an evidence-based patient safety solution that includes a comprehensive evaluation of deceleration patterns. This monograph reviews the past and present science of various deceleration severity scales, evaluates recommendations by EFM experts, and offers a simple 60-Rules option to improve clinical decision making. EFM critical thinking drills are included to improve the learner’s skill and comprehension of this topic.

Original Release Date: December 21, 2016
Review Date: June 21, 2019
Expiration Date: December 21, 2019

Learning Objectives: Upon completion, participants should be able to
1) Critique the past and present deceleration science of various deceleration severity scales.
2) Perform several critical thinking drills that test your knowledge of deceleration risk of fetal
3) Implement risk management solutions that increase your interpretation and management of
    FHR patterns that contain decelerations (late, variable, or prolonged) at highest risk for fetal
    acidemia and injury.

Learning Assessment: There will be a post test for this activity with a minimum performance requirement of 8 out of 10 correct answers.

Estimated time to complete activity: 1 hour

Residents will earn a certificate of completion. Physicians will earn CME credit. 

CME Information - Read

Method and Medium: To obtain CME credit, view the entire online presentation, complete the evaluation and post test and print your certificate online.

CME Credit: 1.0


State Requirements: Based on information from state licensing authorities published by the AMA, this program meets specific CME requirements for the following states:
Connecticut - This activity includes content in Risk Management
Massachusetts - This activity includes content in Risk Management
Pennsylvania - This activity includes content in Risk Management / Patient Safety
Texas - This activity includes content in Ethics and/or Professional Responsibility

CME Disclosure Policy: LAMMICO requires planners, speakers, faculty and all those who influence the content of a CME activity to disclose any financial relationships they have with commercial interests that are relevant to the CME activity. The disclosures shall be reviewed for any conflict of interest and subject to a mechanism for resolution of conflict of interest. A disclosure statement of relevant financial relationships will be made to the audience prior to the activity.

Disclosure: The author, editors and planning committee members for this activity have no relevant financial relationships to disclose.

About the Authors: Dr. Kenneth Brown - Read Bio and Carol A. Curran RNC, MS, OGNP - Read Bio

Managing Editor: Dawer Azizi, MHA, CPHRM, LAMMICO Director of Risk Management

Editor: Sharon Cusanza, MSN, RN, NEA-BC, LAMMICO Senior Risk Management Education Specialist

Content Advisors/Planning Committee Members - Read

Electronic Hardware and Software Requirements - Read

Web Master Contact Information: For assistance, contact Shea Ivey at 866/398-1038 or help@medicalinteractive.com

Disclaimer: This activity is presented as risk management education. It is not legal advice, nor does it establish medical standards of care. Standards of care vary depending on the unique presentation of each patient. The information contained herein is not a substitute for the reasonable discretion of skilled and informed clinicians at the point of care.

Copyright Information: Copyright © 2016

Bibliography: To view and download References & Resources for this presentation, please select the References tab/link below.

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This course is offered through Experix, a wholly owned subsidiary of Physicians Insurance, and is based on more than 30 years' experience in providing continuing medical education. This course is complimentary for Physicians Insurance members.

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