**5. Management algorism HEMOSTASIS for postpartum hemorrhage**

**H** Ask for Help and hands on uterus (uterine massage).

**A** Assess (ABC) and resuscitate (crystalloids 2 Colloids 1 L, oxygen by mask (15 L/min).

**E** Establish etiology (atonic, traumatic, coagulopathy or trauma) ensure availability of blood and administer ecbolic (drugs that contract the uterus: oxytocin or syntometrine intramuscularly).

**M** Massage uterus.

**O** Oxytocin infusion/ prostaglandins: IV/IM/per rectal (second-line medication to contract the uterus).

**S** shift to theater: aortic pressure or anti-shock garment/bimanual compression as appropriate.

**T** Tamponade balloon/uterine packing: after exclusion of tissue and trauma.

**A** Apply compression structure: B-Lynch/modified.

**S** Systematic pelvic devascularisation: uterine/ovarian/quadruple/internal iliac.

**S** Subtotal/total abdominal hysterectomy [6].
