COURSE OUTLINE: MIDTERMS ● Use microdrip tubing for infusions of less than 100

ml/hour and for pediatric patients (to prevent fluid

1. IV THERAPY
overload).
2. LEOPOLD’S MANEUVER
3. EINC
4. BANDAGING
REFERENCE BOOK

IV THERAPY
● The goal of intravenous therapy is to correct or
prevent fluid and electrolyte imbalance
disturbance.
● It allows for direct access to the vascular
system permitting the continuous infusion of
fluids over a period of time.
● To provide safe and appropriate therapy, GAUGE
nurses need to be knowledgeable about the
solution, the reason why the solution was
ordered, equipment needed, procedures
required, how to regulate infusion, maintaining
the system and discontinuing the IV

TYPES OF SOLUTION

ISOTONIC SOLUTION
● Have the same effective osmolality as body fluids.
● Often used to restore vascular volume

HYPOTONIC SOLUTION
● Have a lesser concentration of solutes

HYPERTONIC SOLUTION
● Have an effective osmolality greater than body
fluids.
● D5n5, d5/2ns, D5LR

EQUIPMENT

16 GAUGE
● This size is mostly used in the ICU or surgery
areas. This large size enables many different
procedures to be performed, such as blood
administration, rapid fluid administration, and so
forth.

18 GAUGE
● This size allows you to do most tasks that the 16
gauge can, but it is large and more painful to the
patient. Some of the common uses include
administering blood, pushing fluids rapidly, etc.

MACRODRIP vs. MICRODRIP 20 GAUGE

● This size is better for patients with smaller veins.
MACRODRIP
● Macrodrip IV tubing is the more standard tubing 22 GAUGE
type, and has larger drops of fluid than microdrip ● This small size is good for when patient’s won’t
tubing. need an IV long and aren’t critically ill.
● The macrodrip drip factor is generally somewhere
between 10 and 20 gtt/mL. 24 GAUGE
● Use macrodrip tubing for infusions of at least 100
● This size is used for pediatrics and is usually only
ml/hour.
used as a last resort as an IV in the adult population
MICRODRIP TUBING LINES
● The microdrip drip factor is generally estimated at
60 gtt/mL.

1 I
● Main IV line, used in continuous infusion flow
through the tubing and connects directly into the IV
tubing.
● Secondary intravenous (IV) infusions are a way to
administer smaller volume-controlled amounts of IV
solution (25-250 mL)
● The secondary solution bag is typically hung higher
than the primary infusion bag and is subsequently
"piggybacked" on top of the primary IV infusion.
○ Number of ml to be administered in 1 hour
(ml/hr)
○ Number of drops to be given for a minute
(gtt/min)
● FACTORS INFLUENCING THE FLOW RATE
○ Position of the forearm
○ Position and patency of the tubing
○ Height of the infusion bottle
○ Infiltration of fluid leakage

MAINTAINING THE SYSTEM

TRIFUSE ● Line maintenance involves:
○ Keeping the system intact and sterile
○ Changing IV Fluid containers, tubing and
contaminated site
○ Helping client with self care activities
○ Monitor complications of IV
● PRINCIPLES
○ Always maintain the integrity of the IV line.
○ Never disconnect tubing because it
becomes tangled
○ Never let the tubing touch the floor
○ Never use stopcocks in connecting more
than one solution to a single IV site
○ Clean IV ports with 70% alcohol
IV SITES
● Site chosen for venipuncture includes: CHANGING IV FLUID CONTAINERS, TUBING AND
○ Client’s age DRESSING
○ Length of time ● Patients receiving IV therapy over several days
○ Type of solution used and the condition of required periodic change.
veins ● A sterile dressing over an IV site reduce the
entrance of bacteria

COMPLICATIONS OF IV THERAPY
COMMON IV SITES
CIRCULATORY OVERLOAD
● IV solution infused too rapidly or too great an
amount.
● Signs and symptoms
○ Crackles in the lungs
○ Shortness of breath
○ Cardiac dysrhythmia
● Nursing intervention
○ Reduce of Flow rate and notify patient’s
physician
○ Raise Head of Bed (HOB)
○ Administer oxygen and diuretics if ordered
by AP
○ Monitor VS

REGULATION OF FLOW RATE INFILTRATION

● Number of drops delivered per milliliter of solution ● IV fluid entering subcutaneous tissue around the
varies with different brands and type of infusion set. venipuncture site.
The rate is called Drip factor or sometimes called
drop factor
● 2 methods:
EXTRAVASATION

2 I
 ● Technical term used when a vesicant solution
enters a tissue Possible numbness
● Assessment findings:
○ Skin around catheter site is taut, blanched, 4 Skin blanched, translucent
cool to touch Skin tihgt, leaking
○ Edematous and maybe painful Skin discolored, bruised,
● Nursing intervention swollen
○ Stop infusion Gross edema > 6 inches in
○ Elevate extremity any direction
○ Apply warm, moist or cold compress Deep pitting tissue edema
○ Start new IV line in the other extremity Circulatory impairment
Moderate- severe pain
Infiltration of any amount of
PHLEBITIS blood product, irritant, or
● Inflammation of inner layer of a vein vesicant
● Assessment findings
○ Redness, tenderness, pain and warmth
○ Possible red streak
○ Palpable long cord
● Nursing intervention
○ Stop infusion and discontinue IV
○ Start new IV line in other extremity or
proximal distance to that of the previous
one
○ Apply, warm to moist compress

LOCAL INFECTION
● Infection of catheter skin entry point during infusion PHLEBITIS RATING SCALE
or after removal of IV catheter.
● Assessment finding
○ Redness, heat and swelling of catheter site
○ Possible pus drainage
● Nursing intervention
○ Culture any drainage
○ Clean skin with alcohol: remove catheter
and save for culture
○ Apply sterile dressing
○ Notify physician
○ Start new line

BLEEDING AT VENIPUNCTURE SITE

● Oozing or slow, continues seepage of blood from
venipuncture site
● Nursing intervention
○ Assess if IV system is intact
○ If catheter is within the vein, apply
pressure dressing over site
○ Start new IV line in the other arm
LEOPOLD’S MANEUVER
● are systematic methods of observation and
palpation to determine fetal position, presentation,
lie and attitude.
● preferably performed after 24 weeks of gestation
when fetal outline can be palpated.

COMPLICATIONS OF IV THERAPY FETAL POSITION

● the relationship of the presenting part to a specific
Grade Clinical Criteria quadrant of a woman’s pelvis

0 No symptoms

1 Skin Blanched
Edema < 1 inch in any
direction
Cool to touch
With or without pain

2 Skin blanched, translucent

Edeme 1-6inch in any
direction
Cool to touch
With ot without Pain
FETAL ATTITUDE
3 Skin blanched, translucent ● it is the degree of flexion a fetus assumes during
Gross edema > 6 inches in labor
any direction
Cool to touch
Mild to moderate pain

3 I

● COMPLETE FLEXION (VERTEX) – is the normal
fetal position. (Good Fetal Attitude)
● HOW DOES A COMPLETE FLEXION LOOK
LIKE?
○ Spinal column is bowed forward.
○ Head is flexed forward; so much that the
chin touches the sternum.
○ Arms are flexed and folded on the chest.
○ Thighs are flexed unto the abdomen.
○ Calves are pressed against the posterior
aspect of the thighs.
FETAL PRESENTATION
● It denotes the body part that will first contact the
cervix or be born first.
PERFORM THE SECOND MANEUVER (FETAL LIE)
FETAL LIE
● It is the relationship between the long axis of the
fetal body (cephalocaudal) and the long axis of the
woman’s body.
○ Longitudinal – fetal spine is parallel to the
long axis of the mother.
○ Transverse – fetal spine is perpendicular
(90 degrees) to the long axis of the mother.
PREPARATION
1. nstruct the woman to empty the bladder first. This
will promote comfort and allows for more productive
palpation because fetal contour will not be obscured
by a distended bladder
2. Place the woman in dorsal recumbent position,
supine with knee flexed to relax abdominal muscles.
Place a small pillow under the head for comfort
3. Drape properly to maintain privacy
4. Explain procedures to gain patient’s cooperation
5. Warm hands first by rubbing them together before
placing them over the woman’s abdomen to aid
comfort. Cold hands may stimulate uterine
contractions
6. Use the palm for palpation not fingers
7. During the first three maneuvers, stand facing the
patient. For the last, stand facing the patient's feet.
PERFORM THE FIRST MANEUVER (FETAL
PRESENTATION)
● This maneuver determines whether the fetal head
or breech is in the fundus. (FUNDAL GRIP)
● Upon palpation;
○ the HEAD feels more firm than breech.
○ The head is round and hard; the breech is
well-defined.
○ the head moves independently of the
body;
○ The breech moves only in conjunction with
the body.
● Fetal head is hard, firm, round and moves
independently of the trunk
● Buttocks is soft, symmetric, has small bony
processes, moves with the trunk
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● This maneuver locates the back of the fetus.
(UMBILICAL GRIP)
● Use the other hand to palpate the fetal back and
fetal parts using a circular motion from top to the
lower segment of the uterus.
○ Use deep but gentle pressure
● This method is most successful to determine the
direction the fetal back is facing.
● Fetal back will feel firm and smooth
● Fetal extremities will feel like small irregularities and
protrusions
PERFORM THE THIRD MANEUVER
(ENGAGEMENT)
● This maneuver determines the part of the fetus at
the inlet and its mobility. (PAWLIK’S GRIP)
● Grasp the symphysis pubis by the use of the thumb
and the fingers. Gently grasp the lower portion of
the abdomen just above the symphysis pubis
between the thumb and the index finger and try to
press the thumb and finger together. Determine any
movement and whether the part is firm or soft.
○ Floating- presenting part can be greatly
pushed back and forth
○ Engaged- presenting part is immovable
PERFORM THE FOURTH MANEUVER (PELVIC
GRIP)
● This maneuver determines fetal attitude and degree
of fetal extension into the pelvis. It should be done
only if the fetus is in cephalic presentation.
● Face the client on the foot part
● Place two fingers on both sides of the uterus 2
inches above the inguinal ligament. Presses
downward and inward in the direction of the birth
canal. Allow fingers to be carried downward
DOCUMENTATION
● Documentation within the client’s medical record is
a vital aspect of nursing care or practice.
● The nursing documentation must be accurate,
comprehensive, and flexible.
● Information in the client’s record provides a detailed
account of the level of quality nursing care delivered
to client’s
● Accurate and effective documentation ensures
continuity of care, saves time and prevents
duplication or error in the client's care.
PURPOSES OF DOCUMENTATION
● It is a permanent record of patient’s information.
● Tracks the progress of the patient’s condition during
the hospitalization as well as the status upon
discharge. It serves as an information sheet of the
medications and procedures rendered to the
patient.
● Legal evidence for cross examination whenever
complaints or malpractice claims have been sighted
out
● It serves as the evidence of continuity of care.
● It serves as a research material for retrospective
study.
TYPES OF CHARTING/ DOCUMENTATION
NARRATIVE CHARTING
● traditional form of charting
● a source-oriented record wherein each medical
personnel makes documentation on the patient’s
record in a separate section.
● Advantage:
○ provision of organized section for each
member of the healthcare team
● Disadvantages:
○ Information is scattered throughout the
chart.
○ Review of history and accurate
endorsements must be done.
● Example:
○ Treatment chart
○ Admission sheet
○ Initial Nursing Assessment
○ Graphic Record
PROBLEM- ORIENTED RECORD
● introduced by Lawrence Weed in the 1960s
● gives focus on the problems that patients face.
● With the problems listed, each medical personnel
can contribute and collaborate on the plan of care.
● Advantage:
○ collaboration among medical personnel
● Disadvantage:
○ takes complete and on time assessment of
problem lists.
● Composition:
○ database
○ problem list
○ plan of care
○ progress notes
CONTENTS OF PROGRESS NOTES
SOAP FORMAT
● usually used since it gives a quick look at the
observation of each nurse as well as the nursing
action on each observation.
○ S- Subjective data includes the patient’s
complaints or perception of the present
problem sited
○ O – Objective data includes the nurse’s
observation using his or her clinical eye.
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 ○ A- Assessment
■ includes the inference made by
the nurse from the two types of
data.
■ part wherein the problem is
stated.
■ The nursing problem is stated in a
form of nursing diagnoses using
the NANDA.
○ P – Plan this includes the nursing actions
to be made in order to solve the stated
problem. This part can be revised.
● Additional entries (SOAPIE or SOAPIER)
○ I – Intervention
■ This is the part wherein specific
nursing actions are stated
○ E – Evaluation
■ This is the part wherein the nurse
evaluates the reaction of the
patient or progress of the problem
being solved.
○ R-Revision
■ This is the section that states the
changes made in order to further
resolve the problem.
● Example: Case: A patient with hypersensitivity
reaction secondary to food intake.
○ S – “My skin is so itchy, especially on the
skinfolds.”
○ O – Skin appears to be flushed with
bumps. Irritation noted on the armpit and
inner thighs.
○ A – Altered comfort secondary to food
intake
○ P – Inform the patient not to scratch the
skin, Apply cold compress on the hot
spots, Cut nails in order to prevent skin
scratches, Refer to the physician, Assess
for progress of skin rash
○ I – Instructed not to scratch the skin, Cut
the fingernails short, Applied cold
compress, Referred to the physician
○ E – “I feel more comfortable and I do not
have the urge to scratch my skin.”
○ R – Give antihistamine (Antamin) 1 mg/mL
as deep intramuscular injection to left
deltoid muscle
FOCUS CHARTING
● involves Data, Action and Response category
● Client-focused charting.
● a form of holistic perspective of client’s needs.
● Example:
○ D – Facial grimacing, graded the nape
pain as 7 in the scale of 1 to 10 with 10 as
severe pain
○ A – Given Norgesic Forte per orem as now
does.
○ R – Rated pain as 2 and able to walk on
her own.
GUIDELINES IN CHARTING
PRECISION
● key to clear understanding between colleagues as
well the legalities that surround the charting.
● means being specific when it comes to describing
the observations done, on the other hand, being
accurate must also give factual and measurable
units.
● The accuracy also involves the time element which
is an important part of sequencing the events.
OBJECTIVITY
● use terms that stated objective data and not mere
opinions.
● Viewpoints or hunches are not accepted in charting.
● Transparency should be achieved in documenting
the happenings throughout the nursing care.
WRITE IN PRINT
● It means that you are stating the events clearly.
● not only writing that a few can understand but rather
be more readable among quality assurance
personnel.
FOCUS CHARTING (FDAR)
● It describes the patient's perspective and focuses
on documenting the patient's current status,
progress towards goals, and response to
interventions.
FOCUS
● identifies the content or purpose of the narrative
entry and is separated from the body of the notes in
order to promote easy data retrieval an
communication
DATA
● The statements contain objective and/or subjective
information.
ACTION
● Statements that contain nursing interventions
(basic, perspective, independent) past, present or
future.
● It also contains collaborative orders
RESPONSE
● Evident patient outcomes or response
● INFORMATION FROM ALL THREE
CATEGORIES (DATA, ACTION, and
RESPONSE) should be used only as they are
RELEVANT or AVAILABLE.
● However, all appropriate information should be
included to ensure complete documentation.
● DATA and ACTION are recorded at one hour,
and RESPONSE is not added until later, when
the patient outcome is evident.
● RESPONSE is used alone to indicate a care of
plan goal has been accomplished
● ACTION and RESPONSE are repeated without
additional data to show the sequence of decision
making based on evaluating patient response to
the initial intervention
PURPOSES OF FDAR CHARTING
● To easily identify critical patient issues/concerns in
the Progress Notes.
● To facilitate communication among all disciplines.
● To improve time efficiency with documentation.
● To provide concise entries that would not duplicate
patient information already provided on flow
sheet/checklist. When is FDAR necessary
● To describe a patient problem/ focus/ concern from
the care plan
● To document an activity or treatment that was
carried out
6 I
 ●
●
To document a new findings
To document an acute change in patient's condition ESSENTIAL INTRAPARTUM AND
● To identify the discipline making the entry as well as
the topic of the note
NEWBORN CARE (EINC)
● To describe all specifics regarding patient/family
teaching RECOMMENDED PRACTICES DURING LABOR
● To document a significant event or unusual episode 1. Admission to Labor Room when the parturient
in patient care is already in the active phase
○ Low need for CS by 82%
DO’S AND DON'TS IN FDAR 2. Allow position of choice during 1st stage of
labor, as upright as possible. Allow mobility
● DO time and date all entries.
during labor
● DO use flow sheets/ checklists. Keep information on
3. Allow companion of choice to provide
flow sheet/ checklist current.
continuous maternal support
● DO chart as you make observations.
○ Increase spontaneous vaginal delivery by
● DO write your own observations and sign your own
8%
name. Sign and initial every entry.
○ Low instrumental vaginal delivery by 10%
● DO describe patient's behavior and use direct
○ Low need for pain relief by 10%
patient quotes when appropriate.
4. Routine use of WHO partograph to monitor
● DO record exactly what happens to the patient and
labor progress of labor
care given.
○ Encourages healthcare providers to
● DO be factual and complete.
diligently monitor labor progress and
● DO draw a single line through an error. Mark this
facilitates early identification of abnormal
entry as “error and sign your name.”
labor progress
● DO use only approved abbreviations
5. Limit total number of IE(internal examination) to
● DO use the next available line to chart.
5 or less
● DO document the patient's current status and
○ Low rate of chorioamnionitis by 2%
response to medical care and treatments.
○ Low rate of neonatal sepsis by 61%
● DO write legibly.
○ Low rate of UTI by 34%
● DO use ink.
○ No difference in endometritis with less than
● DO use accepted chart forms.
or more than 5 IEs.
○ The number of vaginal examinations is
● DON'T begin charting until you check the name and
related to the incidence of infection.
identifying number on the patient's chart on each
○ VAGINAL EXAMS to assess cervical
page.
dilatation SHOULD BE DONE only every 4
● DON'T chart procedures or cares in advance.
hours, or more often as necessary (when
● DON'T clutter notes with repetitive or frequently
BOW ruptures, when the woman is bearing
changing data already charted on the flow
down)
sheet/checklist.
● DON'T make or sign an entry for someone else.
● DON'T change any entry because someone tells PRACTICES NOT RECOMMENDED DURING
you. LABOR
● DON'T label a patient or show bias. 1. Routine perineal shaving on admission for labor
● DON'T try to cover up a mistake or incident by and delivery
inaccuracy or omission. ○ Perineal shaving did not protect against
● DON'T “white out” or erase an error. maternal fever, perineal wound infection,
● DON'T throw away notes with an error on them. and perineal wound dehiscence
● DON'T squeeze in a missed entry or “leave space” ○ No neonatal infection was observed
for someone else who forgot to chart. 2. Routine enema during the first stage of labor.
● DON'T write in the margin. ○ Less fecal soiling during delivery by 64% is
● DON'T use meaningless words and phrases, such the only clear benefit
as “good day”or “no complaints” ○ Enemas do not protect against maternal
● DON'T use notebook paper or pencil. puerperal infection, episiotomy
dehiscence, neonatal infection and
GENERAL GUIDELINES FOR FOCUS CHARTING neonatal pneumonia
● Focus charting must be evident at least once every 3. Routine NPO
shift. ○ No evidence of improved outcomes for
● Focus charting must be patient oriented not nursing mother nor newborn if on NPO
task-oriented. ○ Very small probable risk of maternal
● Indicate the date and time of entry in the first aspiration mortality -- 7/10 M births
column ○ For normal, low risk birth, no need for NPO
● Separate the topic words for the body of notes except when intervention is anticipated
● Focus note written on the second column. 4. Routine IVF
● Data, Action and Response on the third column ○ Advantage is to have ready access for
● Sign name ( e.g. Geraldine M. Amiscaray, RN or G. emergency med
Amiscaray,RN) for every time entry ○ Disadvantages:
● Document only patient’s concern and/or plan of ■ interferes with the natural birthing
care e.g. health teaching per shift. Hence, process
GENERAL NOTES ARE NOT ALLOWED! ■ restricts women's freedom to
● Document patient’s status on admission, for every move
transfer to/from another unit, or discharge. ■ Not as effective as food and fluids
● Follow the Do’s of documentation in labor to treat/prevent
● Use BLUE or BLACK ink of pen for AM and PM dehydration, ketosis or
shift, RED ink for NIGHT shift. electrolyte imbalance

7 I
5. Routine amniotomy to shorten spontaneous
labor
○ There is evidence that amniotomy reduces
the risk of dysfunctional labor by 25%.
However, there is no difference in the
duration of labor.
6. Routine oxytocin augmentation
○ Should be used by doctors only when
indicated and in facilities where there is
immediate access to CS
○ NEVER use IM oxytocin before birth of the
infant because its dosage cannot be
adapted to the level of uterine activity
RECOMMENDED PRACTICE
1. Upright position during delivery
○ Improved anterior-posterior and transverse
diameters of pelvic outlet → enhances
fetal movement through the maternal
pelvis in descent for birth
○ Increase efficiency of uterine contractions
○ Improved fetal alignment
2. Encourage pushing only when the mother has the
urge to push
3. Selective (non-routine) episiotomy
4. Perineal Support and Controlled Delivery of the
Head
○ During delivery of the head, encourage
women to stop pushing and breathe
rapidly with mouth open
○ Keep one hand on the head as it advances
during contractions while the other hand
supports the perineum.
5. Active Management of the Third Stage of Labor
(AMTSL)
○ Administration of uterotonic oxytocin
within one min of delivery of the baby.
○ Controlled cord traction with counter
traction on the uterus
○ Uterine massage
6. Properly- timed cord clamping 1-3 mins after birth or
when cord pulsations stop
7. Controlled cord traction with counter-traction on the
uterus to deliver the placenta
8. Uterine massage after placental delivery
○ Fundal massage of the uterus stimulates
uterine contraction and helps to prevent
PPH.
PRACTICES NOT RECOMMENDED DURING
DELIVERY
1. Perineal massage in the 2nd stage of labor
2. Fundal pressure during the 2nd stage of labor
○ Fundal pressure during the 2nd stage of
labor refers to the manual force applied
externally to the abdomen at the level of
the uterine fundus to expedite delivery.
Although uterine rupture was not evaluated
by studies, the CPG Panel placed a high
value on avoiding maternal injuries like
uterine rupture and fetal death
POSTPARTUM CARE
● Routine inspection of birth canal for lacerations
● Inspection of placenta & membranes for
completeness
● Early resumption of feeding
● Uterine massage
● Prophylactic antibiotics for 3rd/4th degree tears
● Early postpartum discharge
4Ps of LABOR
PASSAGEWAY
●
PASSENGER
● Presentation of the fetus “part of the fetus that
enters the pelvis first” (breech, transverse)
● Size of the fetus, moldability of the fetal skull
● The fetal head is considered as the widest part of
the body, which makes it most difficult to pass
through the vaginal canal. The passage of the
passenger depends on the bonds, sutures, and
fontanelles.
POWER
● Quality, force, and frequency of the uterine
contractions which acts as the primary force moving
the fetus thru the maternal pelvis during the first
stage of labor. The woman in labor adds voluntary
pushing force to force of contractions during the 2nd
stage of labor to propel fetus thru the pelvis
● To know about the uterine contractions, you have to
assess for the following:
○ Increment - beginning, building of pressure
○ Acme- refers to the most intense part of
the contraction
PSYCHE
● Psychological response of the mother to the birth
process can also influence the labor. The mother’s
attitude toward labor and her preparation for labor
and childbirth, previous childbirth experience and
support from the significant others contributes to the
psyche of the mother.
● Following can also affect her psychological
response to the birth processL
○ Emotional status
■ Includes anxiousness, drug use
and psychiatric history. Fear and
anxiety can exacerbate pain
during labor
○ Culture
■ Background may influence
response to pain. Some mothers,
during labor, are verbally
expressive, while some only
moans
FOUR TYPES OF PELVIS
GYNECOID
● Fifty percent (50%) of all women has gynaecoid
pelvis.
● Rounded, oval shape
● Easy vaginal delivery
● Considered “normal female pelvis”
ANDROID
8 I
 ● Twenty percent (20%) of women are of the android
type of pelvis
● Makes vaginal delivery difficult
● True male pelvis
ANTHROPOID
● Twenty to twenty-five percent of women has
anthropoid pelvis
● Women with anthropoid pelvis usually give birth by
assisted vaginal birth with forceps
PLATYPELLOID
● Less than 5% of women have flattened pelvis.
● Makes vaginal delivery difficult
1. Stretch out the piece of fabric that will be used. It is
preferred to use a long stretch of fabric to create
more triangular bandages for future use
2. Cut the fabric into a square of an estimated 3 feet
by 3 feet. Once cut, cut the square in half along the
diagonal axis to make two triangles
3. To sterilize bandages, one may opt to put the
bandages in boiling water or soaking it in hydrogen
peroxide or any other disinfectant. Allow it to dry
before using. Sterilizing will greatly reduce risks of
infection
4. Triangular bandages are generally recommended to
be ironed for easier use. Moreover, this will make
the triangular bandage easier to store in case of
need

MEDICAL USES FOR A TRIANGULAR BANDAGING

MECHANISMS OF LABOR
● Sling (arm or elevated)
DESCENT ● Head injury
● Refers to the downward passage of the presenting ● Sprained ankle
part through the pelvis. ● Tourniquet
● As the head engages and descends, it assumes an ● Bleeding wounds
occiput transverse position because that is the ● Splint for broken legs
widest pelvic diameter available for the widest part ● Eye injuries
of the fetal head ● Fractured jaw
● Shoulder injury
FLEXION ● Hip wrap
● Flexion of the head occurs passively as the head ● Minor hand burns
descends due to the shape of the bony pelvis and
the resistance offered by the soft tissues

INTERNAL ROTATION
● Rotation of the presenting part from its original
position, usually transverse with regard to the birth
canal to the anterior position as it passes through
the pelvis

EXTENSION
● Extension occurs when, as the occiput of the fetal
head is born, the back of the neck stops beneath
the pubic arc and acts as a pivot for the rest of the
head. This makes the head extends and the other
parts of the head, the face and chin, are born

EXTERNAL ROTATION
●

BANDAGING
● Covering a break in the skin helps to control
bleeding and protect against infection.

TRIANGULAR BANDAGING
● Made from a strong type of cloth which has been
cut into a right-angle triangle
● Present in most first-aid kits as it will be used to
help treat and manage many various injuries, such
as fractures and even bleeding
● Dimensions: 40x40x56 inches or 102x102x142cm

CRAVAT
● The cravat is a neckband, the forerunner of the
modern tailored necktie and bow tie, originating
from a style worn by members of the 17th century
military unit known as Croats.
● The modern British “Cravat” is called an “ascot” in
American English

HOW TO MAKE TRIANGULAR BANDAGE

9 I