Peripartal life-threatening haemorrhage - 2013

You are called as an anaesthetist to the delivery room to the 30 year old woman in labour (V-gravida, III-para). The delivery was physiological in term, performed in epidural analgesia (I. stage of labour 8 hours, II. stage of labour 10 minutes), the boy was delivered (3950 g, 52 cm, Apgar score 8-10-10). At the beginning of third stage of labour strong bleeding from genitals appear, there is a blood loss of 500 ml within 5 minutes. Placenta isn‘t delivered. Woman is conscious, pale, tachycardic, free of signs of respiratory insufficiency . What will be your next step?
30
years
woman
RR
20 /min
HR
124 /min
SpO2
91 %
BP
87/60 (69) mmHg