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Introduction to the Quick Reference Handbook for Obstetric Emergencies (Obs QRH)

The Quick Reference Handbook for Obstetric Emergencies (Obs QRH) is a collection of action card guides for medical and resuscitation emergencies in hospitals. These guides are intended to help the multidisciplinary teams caring for birthing people and their babies. The guides have purposely been written in a similar format to the Association of Anaesthetists Quick Reference Handbook and the Resuscitation Council UK Quick Reference Handbook, to aid familiarity.

The aim is to ensure a co-ordinated, structured and all-encompassing response to an emergency, at a time when care givers may be unfamiliar with other team members and have a high cognitive load.

Please ensure that you are familiar with the Obs QRH, so that these guides can be of maximum help to the team, at the time of a crisis.

Remember, simply having the Obs QRH in your department won’t help in a crisis; it’s a tool that teams must practise using. For more information see implementation

The Obs QRH is not a substitute for learning and practicing clinical skills. Nor is it a substitute for being familiar with more detailed guidelines and algorithms, such as those for managing obstetric cardiac arrest or newborn resuscitation.

It's essential that clinicians learn about these and practice their implementation elsewhere. For example, it's expected that in using the Obs QRH guideline for managing cardiac arrest, clinicians will already have underlying knowledge of conditions causing cardiac arrest and will be competent in providing advanced life support.

The Obs QRH is also not intended to be used as a rule book every single time one of the guideline situations is encountered. For instance, controlling a postpartum haemorrhage can often be achieved rapidly, using simple measures. The postpartum haemorrhage guideline becomes useful if the situation is out of the ordinary or becomes unremitting. Conversely, for the more immediate and uncommon problems, such as obstetric cardiac arrest, the guidelines should be used from the outset to help avoid missing out useful steps in resolving the situation.

The guidelines in the Obs QRH are not intended to be standards of medical care. The ultimate judgement about a particular clinical procedure or treatment plan must be made by the clinician in light of the clinical data presented and the diagnostic and treatment options available.


For more information on the Obs QRH and how to use them in a crisis read Finding your way around the Obs QRH. If you intend to introduce the Obs QRH in your unit, you should read and follow the implementation guide. We also recommend joining the Emergency Manuals Implementation Collaborative for online community-based support in implementation.

You can download the 'as is' PDF version of the Obs QRH, or if you wish to modify it, you can download the editable Word version.

If you have any feedback or comments about the Obs QRH, please contact the OAA Secretariat

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