“HANDLE” RESPONSIBILITIES “CORD DRESS” RESPONSIBILITIES

1. Wear mask. 1. Wear mask.

2. Do proper gloving. Observe sterile technique. 2. Do proper gloving. Observe sterile technique.
3. Arrange instruments in the DR pack (1 Kelly curve,1 Kelly 3. Ask for the baby’s sheet.
straight, 1 surgical scissors, 1 bandage scissors,1 needle 4. Place the sheet on the anterior chest with both arms covered.
holder, 1 forceps with teeth, 1 kidney basin, 1 abdominal 5. Ask “handle” for the bulb syringe.
sheet, 1 bulb syringe, OS and sanitary napkin for perineal 6. Once baby is out, suction mouth and nose properly. Do it fast
support). but gently.
4. Place the abdominal sheet on the mother’s abdomen. Instruct 7. Empty it on the pail below.
her not to touch it. 8. Continue suctioning until the cord is cut.
5. Prepare the sanitary napkin. 9. Receive the baby. Use the baby’s sheet and NEVER WITH
6. Give bandage scissors if the patient is for episiotomy. YOUR GLOVED HANDS ONLY.
7. Once the baby’s head is visible, support the perineum. 10. Do not let the clamp dangle. Hold it. If you find it difficult, then
8. Continue supporting until the whole body of the baby is out. place it on the baby’s abdomen. Just be careful that it doesn’t
9. *Take note of the time. Verbalize loudly but do not shout. (e.g. cut the baby’s skin.
“Baby Out, 7:30 am”) 11. Take the baby to the crib.
10. Once baby is out, drop the napkin in the dry pail. 12. Clean and dry the baby using the baby’s sheet.
11. Clamp the umbilical cord. 13. Wipe with OS soaked in water with Lactacyd. (face, head,
a. Clamp using K. Curve first. Then, milk the cord towards the anterior torso, upper extremities, genitalia, lower extremities
baby. and posterior torso).
b. Clamp towards the baby’s side using the K. straight. 14. Do not force to remove all the vernix caseosa.
12. Cut the cord using the surgical scissors. Once cut, do not let 15. Change dirty linen with a clean one.
go of the two clamps. 16. Change gloves. Observe sterile technique.
13. Give the straight clamp to the “cord dress”. ♣ CORD DRESSING AND CARE
14. Give the curve clamp to the doctor. a) Wipe the cord with cotton soaked in
15. Prepare the kidney basin. Betadine from base to top. Do this twice.
16. Catch the placenta using the basin. b) Place the cord clamp approximately 1 inch
17. *Take note of the time. Verbalize loudly but do not shout. (e.g. above the base and lock (you will hear a
“Placenta Out, 7:35 am”) clicking sound).
18. *Take the postpartum BP. Record. c) Cut the cord above the clamp (leave about 1
19. Do perineal flushing. Ask assistant to help. mm cord before cutting).
20. Assist in suturing. d) Ask assistant to give the cut cord to the
♣ SUTURING/EPISIORRHAPHY “handle” to be discarded with the placenta.
a) Prepare Lidocaine. e) Wipe the cord and the clamp with cotton
b) Use 3 cc syringe. soaked in Betadine from top to base. Do
c) Aspirate until syringe is full. Repeat as this twice.
ordered. f) Wipe the cord and the clamp with cotton
d) *Open suture pack. Drop on mayo table. soaked in alcohol from top to base. Do this
e) Attach needle to needle holder. NOTE: The twice.
tip of the needle holder should hold the 17. Take the baby’s measurements.
blunt end of the needle with the sharp end a) Weight - in kgs or grams
facing your left and facing up. b) Length (from tip of head, down the back,
f) Arrange instruments and assist the doctor. buttocks, back of thigh, popliteal area, down to
g) KEEP STERILE! the heel) - in cm
♣ AFTER CARE (done with the assistant) c) Head circumference (above eyebrows) - in cm
a) Do perineal flushing. d) Chest circumference (nipple line) - in cm
b) Wipe the inguinal area using wet OS. e) Abdominal girth - in cm
c) Include the thigh and other parts especially 18. Administer Erythromycin 1 squirt OU from inner to outer
those with blood. canthus. Try to open the baby’s eyes but do not force.
d) Wash the mother’s feet. 19. Administer Vit. K at left thigh.
e) Drop the Kelly pad in the big pail. a) If wt. is above 2 kgs: 0.1 ml IM
f) Use the abdominal sheet to clean the b) If wt is below 2 kgs: 0.05 ml IM
buttocks of the mother. Drop the sheet in 20. Take vital signs.
the dry pail. a) Temperature (rectal: 2-3 mins)
g) Put on the mother’s diaper. Change her b) Heart Rate (apical: 1 full minute)
clothes. c) Respiratory Rate (observe rise and fall of chest: 1
h) Bring the mayo tray and the pails in the full minute)
wash room. 21. Put on diaper and clothes.
i) Place the placenta in a plastic. Weigh it. 22. Take the baby’s right and left footprint.
j) Get the cord from the “cord dress”. 23. Place the baby’s identification tag (blue for males then pink for
k) Put Zonrox in the plastic with placenta. females). Write the baby’s weight at the back of the tag.
Throw it in the red placenta container inside 24. Wrap the baby snugly.
the big cabinet in the wash room. 25. Bring the baby to the nursery for Hepatitis B injection.
l) Clean the instruments. Place them in the 26. Do after care. Discard materials in the proper containers.
dryer.
m) Clean the pails and the Kelly pad. *ASSISTANT of the CORD DRESS:
n) Strain the contents of the big pail. i. While waiting for the baby to be born, prepare 2 kidney basins
o) Place whatever is collected in the strainer with water on the cord dress table.
in the plastic (that which is used in the dry ii. Mix a little Lactacyd on ONE basin only.
pail) and place them in the “infectious iii. Put sterile OS in the basin with Lactacyd.
garbage can”. iv. Prepare the cord dress tray. Make sure it is complete
p) Once done, clean your used gloves (alcoholized cotton, cotton with Betadine, bandage scissors
thoroughly. Let it dry. and OS).
♣ TRASNSPORT v. Prepare the baby’s “lampin”, diaper, cord clamp and baby’s
a) Get the stretcher outside the DR. clothes.
b) Transfer the mother.
c) Side rails up.
d) Transport to the Receiving Area.
e) Call the institutional worker so that the BASED ON CCMC PROTOCOL. THIS MAY NOT BE APLLICABLE TO OTHER
mother may be transported to the ward. INSTITUTIONS.

“ASSIST” RESPONSIBILITIES
1. You are in charge of the baby’s chart.
2. Supply the data asked.
3. Take note of important times (Baby Out and Placenta Out).
4. Once the chart is done, give it to the nurse on duty.

BASED ON CCMC PROTOCOL. THIS MAY NOT BE APPLICABLE TO

OTHER INSTITUTIONS.