EMERGENCY DEPARTMENT · WALL POSTER

JADA System Insertion

DECIDEPPH persisting after massage and uterotonics. · Cervical dilation ≥3 cm, confirmed by direct visualization, before attempting insertion. · Contraindicated: ongoing pregnancy · untreated rupture · inversion · cervical cancer · cervix <3 cm. · Extra caution, involve OB: uterus under 34 weeks size, coagulopathy, accreta. · An adjunct to the rest of the PPH pathway.

STEPS · ◆ KEY STEP — LOGGED WITH ITS TIME

TECHNIQUE — STEP BY STEP

First rule out lacerations and retained products.
Empty the bladder, then connect the canister and tubing to the vacuum source.
Draw ALL air out of the Cervical Seal first. Never inflate it with any gas.
Confirm ≥3 cm cervical dilation, compress the loop near its tip, insert loop-first. No force. ◆ JADA INSERTED
Loop in the frontal plane, Seal Valve at 6 or 12 o'clock, seal at the external os.
Fill the Cervical Seal with 60 mL sterile fluid; add up to an additional 60 mL as needed for full os coverage.
Set the vacuum to 80 ± 10 mmHg while occluding the end of the tubing, then connect the tubing to the device.
Watch for blood in the tubing and improving tone. Vacuum must never exceed 90 mmHg.
Tape the tubing to the inner thigh without tension once flow/tone response is confirmed.

MONITORING & REMOVAL

Leave in place until bleeding is controlled for at least 1 hour and the uterus is firm with a stable patient.
Disconnect the vacuum, monitor ≥30 min with it still in place. Minimum indwell ~1.5 h. ◆ JADA VACUUM DISCONNECTED
Maximum indwell 24 hours.
Removal: DISCONNECT THE VACUUM FIRST. Then empty the seal, steady the fundus, withdraw.
Consider prophylactic antibiotics for prolonged use, per local practice.

EQUIPMENT

JADA System single-use kit, plus the collection canister.
Regulated vacuum source able to hold a gauge-visible 80 ± 10 mmHg.
Two sterile syringes: one to draw air out of the seal, one 60 mL of sterile fluid.
Straight catheter or Foley kit — empty the bladder before insertion.
Speculum, sterile gloves, antiseptic prep — to visualize and confirm cervical dilation before inserting.
Tape — secures the tubing to the inner thigh without tension once running.

IN THE KIT — 6 ITEMS · OB / NEONATAL CART · DRAWER 4 · POSTPARTUM HEMORRHAGE

JADA System single-use kit ×1
Sterile syringes — one to draw air from the cervical seal, one 60 mL of sterile fluid ×2
Straight catheter or Foley kit — empty the bladder before insertion ×1
Speculum ×1
Antiseptic prep + sterile gloves ×1
Tape — secures the tubing to the inner thigh, no tension ×1

ALSO NEEDED — NOT IN THE KIT

Regulated vacuum source — wall regulator or portable pump — able to hold a controlled, gauge-visible 80 mmHg. Not in the bag.
DRAFT — not yet assembled or signed off. Empty the bladder first. The vacuum source has to hold a gauge-visible 80 mmHg — check the regulator on the monthly check.

FIGURE

Set the vacuum to 80 mmHg (acceptable range 70–90); do not exceed 90. The seal is confirmed by fluid in the tubing, not by air — a column of air means the seal has failed and the device is not tamponading. Stored in PPH / drawer 4.

CERVICAL DILATION ≥3 CM REQUIRED TO INSERT

VACUUM 80 ± 10 MMHG STANDARD — NEVER EXCEED 90 MMHG

CERVICAL SEAL FILL 60 ML, +UP TO 60 ML MORE PRN

CONTROL ≥1 HR, THEN ≥30 MIN MONITORED OFF-VACUUM BEFORE REMOVAL

MAXIMUM INDWELL TIME 24 HOURS

PITFALLS & PEARLS

Filling the Cervical Seal with air instead of sterile fluid.

Removing the device while vacuum is still connected — disconnect first, every time.

Forcing insertion against resistance.

No flow or tone change: check for an air leak or incomplete seal coverage.

Losing track of insertion time — write it down; 24 hours is the maximum.