HELPERR Mnemonic

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The HELPERR mnemonic is an established protocol for shoulder dystocia prevention. This involves seven steps that can be taken to reduce risk of injury during shoulder dystocia complications.

H - Call for help

The appropriate personnel with the necessary equipment.

E - Evaluate for episiotomy

A surgical incision of the perineum during childbirth to facilitate delivery.

L - Legs (the McRoberts maneuver)

A maximal flexion and abduction of the maternal hips.

P - Suprapubic pressure

A hand of an assistant should be placed suprapubically over the fetal anterior shoulder, applying pressure in a downward and lateral motion on the posterior aspect of the fetal shoulder.

E - Enter maneuvers (internal rotation)

An attempt to manipulate the fetus to rotate the anterior shoulder into an oblique plane and under the maternal symphysis.

R - Remove the posterior arm

Grasping and pulling directly on the fetal arm may fracture the humerus and should be avoided.

R - Roll the patient

The patient rolls from her existing position to the all-fours position.

If your child suffered an injury from shoulder dystocia and you feel it may have been the result of medical malpractice, please contact us today for a FREE consultation with an experienced birth injury attorney. We can investigate the circumstances surrounding your case, inform you of your legal rights and options, and help you recover compensation for your losses.