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Delivery patient Handling delivery patient

How to Handle Delivery Patient

Purpose

  • To maintain sterile field during labor.
  • To maintain health promotion of mother and fetus
  • To prevent health hazards which mother and fetus may undergo.
  • To assist doctor in labor procedure.
  • To detect and provide proper management of any hazards to delivery patient as early as possible.

Scope

Mothers who are in labor.

Definition-Delivery patient

Managing a normal vaginal delivery involves the hand maneuvers used to assist the baby’s birth, immediate care of the new born and the delivery of the placenta.

Applicable Areas

Gyneac & Obstetric Department

Responsibility

Consultant, Medical Officer, Staff Nurse, Auxillary Nurse Midwife and Head Nurse.

Equipment

  • 2 gowns, 2 gloves, 2 masks
  • 5 towels
  • 2 leggings
  • Dressing and tissue gauze
  • Catheter
  • Syringes, one for local anesthesia and one for methergine.
  • Instruments : 2 cokhers, 2 arteries, 1 scissor, 1 needle holder, sims, 1 tissue forceps, toothed and non-tooth..
  • Chromic catgut suture.
  • Newborn tray, clamp, identification band, suction tube, alcohol swab, scissor,

Procedure

  • Check good place, light and complete equipment.
  • Put delivery patient (mother) in lithotomy position.
  • Identify signs of 2nd stage of labor.
  • Explain procedure to the mother.
  • Put on mask, overhead and scrubbing, gowning and gloving.
  • Arrange equipment on the tray according to the sequence of procedure.
  • Perineal care with antiseptic solution.
  • Draping the mother according to the procedure.
  • Evacuate mother bladder by catheterization.
  • Following-up labor progress by PV examination.
  • Instruct mother to bear down during contractions and relax in between.
  • Give the doctor the syringe of local anesthesia.
  • Help doctor in providing local anesthesia.
  • Observe presenting part for crowning occur when 3-4 cms. of the head appear during uterine contraction.
  • Give scissor to the doctor to cut episiotomy according to the procedure.
  • Assist the doctor to support perineum with sterile dressing and maintain good flexion of the fetal head at the same time.
  • Deliver head and expulsion of fetal body.
  • Clamping 1st cocker on the cord far from the mother at least 20 cm.
  • Evacuate small segment.
  • Clamping 2nd cocker on the cord far from the first about 10 cm.
  • Cutting cord between 2 cokher down ward.
  • Assist doctor in expulsion of placenta.
  • Inspection of placenta by examining fetal and maternal parts.
  • Give Inj. Methargine to circulating nurse as per doctor’s advice.
  • Perineal care and change the sheet which is under the mother.
  • Assist the doctor in episiotomy repair.
  • Ensure the uterus is well contracted.
  • Perineal care.
  • Explore area of episiotomy.
  • Swabbing with Betadine on the episiotomy site.
  • Put sterile dressing on the perineal area.
  • Remove all towels from the mother.
  • Collect equipment and clean instrument.
  • Wash hands and prepare delivery setting to new labour.
  • Report complete information about mother and baby.

Documentation

Nurse’s Observation Sheet.