Abstract
Objective Aim of this study was to introduce posterior axilla sling traction (PAST) in delivering
providers and nursing staff as an adjunct to the management of shoulder dystocia and
evaluate comfort in performing the maneuver.
Methods A presimulation questionnaire had given to all participants. A brief training on
how to perform PAST was also given. A simulated shoulder dystocia was run where usual
maneuvers failed. Participants used PAST for delivery of posterior shoulder, delivery
of posterior arm, and to assist with rotation. Participants were then given a post-simulation
questionnaire. A Chi-squared test was used to evaluate comfort with performing the
procedure pre and post-simulation.
Results Data were collected from 43 participants at pre and post-simulation. Designations
(attending, resident, midwife, registered nurse) and responses were recorded to the
questionnaires. There was a statistically significant increase in the number of providers
and nurses who would feel comfortable using PAST for shoulder dystocia management
and for rotational maneuvers. Ninety-three percent of participants would consider
using PAST in future shoulder dystocia when usual maneuvers failed.
Conclusion PAST is an adjunct to management of shoulder dystocia that has not previously been
taught in our facility. The majority of participants in our simulation felt comfortable
with using PAST.
Keywords
simulation - shoulder dystocia - posterior axilla sling traction - obstetric emergency
