Friday, February 02, 2007

The DR nurse's role

If you're a first-timer in the Delivery Room you might find this useful. These were our responsibilities in St. Anthony Mother and Child Hospital (The DR nurse's role varies from hospital to hospital):

If you're the Handle:
  • Prepare the anesthesia (Lidocaine) using a 5cc syringe
  • Prepare the OS
  • Support the patient's perineum when there is already 'crowning' (when the baby is about to be expelled) using a sterile pad (In the Cabrite Birthing Home in Labangon and Estardo Birthing Home in Lapu-Lapu, we were actually allowed to be the ones to pull the baby out)
  • Note the time of delivery and the time the placenta was expelled
  • Assist the doctor during suturing if an episiotomy was done (prepare the needle and suture)
  • Do SOAPIE for the mother after the procedure

If you're the Assist:

  • Wipe the baby's mouth with an OS
  • Clamp the umbilical cord at the middle with a Kelly curve forcep
  • 'Milk' the cord (towards the baby)
  • Clamp the cord with the Kelly straight and cut in the middle with a Mayo scissor
  • Bring the baby to the table prepared for him/her
  • Do suctioning (the mouth first and then the nose)
  • Wipe the baby's body thoroughly using OS soaked in water and Lactacyd
  • Do SOAPIE for the baby after the procedure

If you're the Cord Care:

  • Wipe the cord with OS soaked in alcohol from the bottom up at least 3 times
  • Clamp the cord this time with a, um, cord clamp (several inches from the baby's belly)
  • Wipe the top of the newly-cut cord with OS soaked in alcohol at least 3 times
  • Wipe also the base of the cord
  • Measure the baby's head circumference, chest circumference, and length in centimeters
  • Weigh the baby
  • Administer Gentamycin eye drops
  • Administer Vit. K IM at the anterior portion of the left thigh
  • Administer Hepa B vaccine at the anterior portion of the right thigh (if ordered)
  • Take the baby's footprints and the mother's thumb prints
  • Take the baby's vital signs
  • With the baby clothed, bring him/her to the mother for 'latching on' and note the time (We were advised to allow the baby to latch on for not less that 30 minutes)

I wonder why we didn't do APGAR scoring. Murag ang staff nurse ra'y nagkuha.

If your patient is still in the labor room, take her vital signs every hour. Do Leopold's maneuver to determine the baby's position and take his/her heart rate, using a stethoscope or a cardiotocograph. Monitor also the contractions (its duration, interval and frequency) every 15 minutes, or continuously if the labor is already active. Inform your CI for any abnormality.

No comments:

eXTReMe Tracker