Checklist Pediatric Nursing DRAFT

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Place a “” in box against steps/task if it is performed SATISFACTORILY, an “X” if it is NOT performed
SATISFACTORILY, or N/O if not observed.
SATISFACTORY: PERFORMS THE STEP OR TASK ACCORDING TO THE STANDARD PROCEDURE OR GUIDELINES
UNSATISFACTORY: UNABLE TO PERFORM THE STEP OR TASK ACCORDING TO THE STANDARD PROCEDURE OR GUIDELINES
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NOT OBSERVED: STEP OR TASK NOT PERFORMED BY PARTICIPANT/STUDENT DURING EVALUATION BY TRAINER/TEACHER
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PROCEDURE CHECKLIST
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PEDIATRIC NURSING
B.Sc.NURSING
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CHECKLIST
FOR
CHILD HEALTH NURSING PROCEDURES
TABLE OF CONTENT
SL. NO. TOPIC PAGE NO.
1. Hand washing 3
2. Putting and removing gloves 4
3. Weighing of Newborn -Electronic 5
4. Weighing of Newborn -Using color coded Sling Scale 6
5. Temperature Recording –Mercury Thermometer 7
6. Temperature Recording –Digital Thermometer 8
7. Maintaining temperature using Radiant warmer 9
8. Care of newborn in incubator 10
9. Baby bath 12
10. Use of Suction machine- Electrical 15
11. Use of Suction machine-Foot/ Hand operated 16
12. Use of Phototherapy machine for newborns with 17
Jaundice
13. Use of Glucometer 18
14. Inserting feeding tube and tube feeding of a baby 19
15. Preparation of supplementary feeds 21
16. Using Pulse Oximeter 22
17. Oxygen administration 23
18. Oxygen Concentrator 24
19. Using Multi dose inhaler 25
20. Using Multi dose inhaler with spacer 26
21. Using Nebulizer 27
22. Preparation and use of ORS 28
23. Administration of Zinc tablet 29
24. Perform Immunization –BCG 30
25. Perform Immunization – DPT 31
26. Perform Immunization –TT 32
27. Perform Immunization – Measles 33
28. Perform Immunization – OPV 34
29. Perform Immunization –Hepatitis B 35
30. Injection safety measures 36
31. Applying Reverse Spiral Bandage 37
32. Applying Figure of eight bandaging 38
1
33. Applying Spiral Bandaging 39
34. Care of child in plaster cast 40
35. Assisting in lumbar puncture 41
36. Essential newborn care 44
37. Newborn resuscitation 45
38. Examination of newborn 46
39. Pediatric CPR- Basic Life support 48
2
CHECKLIST FOR HAND WASHING

SI STEP/TASK 1 2 3 4 5
NO
1. Remove rings, bracelets, and watch.
2. Wet hands in clean running water. Applies soap.

Vigorously rub hands together in following manner
3.
 Palms, fingers and web spaces
4.  Back of hands
5.  Fingers and knuckles
6.  Thumbs
7.  Fingertips and creases
8.  Wrist and forearm up to the elbow
9. Thoroughly rinse hands in clean running water.
10. Dry hands using clean personal towel, paper towel, or allows to air dry.
3
CHECKLIST FOR PUTTING ON AND REMOVING OF HLD/STERILE GLOVES

NO
PUTTING GLOVES
1. Remove rings, bracelets, and watch.
2. Wash hands thoroughly with soap and water and dry with a clean, dry cloth or air dry.
Lay package on clean, dry, flat surface. Open glove packaging without contaminating
gloves.
3. Or
Removes glove(s) from high-level disinfected container using high-level disinfected
ring forceps. Avoid contaminating gloves.
Grasp inside edge of the cuff of the right glove with the thumb and first two fingers of
4.
your left hand. Avoid contaminating the outside of the glove.
Holding your hands above your waist, insert right hand into the glove and pull the
5.
glove up and over the hand.
Grasp inside edge the cuff of the left glove with the thumb and first two fingers of the
6.
gloved hand.
Without contaminating either glove. Insert left hand into the glove and pull the glove
7.
up and over the hand.
Keeping hands above waist, adjust the gloves, touching only the high-level disinfected
8.
or sterile area.
REMOVING GLOVES
With right hand, grasp outer surface of wrist of left glove, just below the thumb. Peel
9. the glove off (without contaminating wrist and hand). Drop contaminated glove into
0.5% chlorine decontamination solution.
Place fingers of ungloved hand under the cuff of the right glove (without
10. contaminating ungloved hand) peel second glove off. Drop contaminated glove into
0.5% chlorine decontamination solution.
11. Wash hands thoroughly with soap and water and dry with a clean, dry cloth or air dry.
4
CHECKLIST FOR WEIGHING OF NEWBORN

NO
1. Places the weighing scale on a flat and stable surface.
2. Checks whether pan is centrally placed
3. Checks whether the pan is free to move
4. Places towel/ autoclaved paper on the pan
5. Adjusts the setting to “0”
6. Undresses the baby and places the undressed baby on the weighing machine
7. Places baby centrally on the pan, Pacifies the baby if it is vigorous.
8. Records the reading in the register.
9. Informs the mother about baby’s weight
10. Removes the baby from the pan and dresses the baby quickly.
11. Gives the baby to the mother

12. Cleans the pan if it is soiled
5
CHECKLIST FOR WEIGHING OF NEWBORN-USING COLOR CODED

SLING SCALE
N
O
1. Places the sling on scale
2. Holds the scale by top bar off the floor, keeping the adjustment knob at eye level
3. Turns the screw until its top fully covers the red and “0” is visible
4. Removes sling on hook and place it on a clean cloth on the ground
5. Places baby with minimum clothes on, in sling and replaces the sling on the hook
6. Undresses the baby and places the undressed baby on the weighing machine
7. Holds top bar carefully, as she stands up, lifts the scale and sling with baby off the
ground, until the knob is at eye level.
8. Reads the weight
9. Gently puts the sling with baby in it, on the ground and unhooks the sling
10. Removes the baby from the sling and hands over the baby to mother
11. Records the weight and informs the mother.
12. Places the sling on scale
6
CHECKLIST FOR: TEMPERATURE RECORDING

(Using mercury thermometer)
N
O
1 Takes thermometer out of box, holds at broad end
2 cleans the shining tip with cotton spirit and waits till dry
3 Checks the position of column of mercury if above the junction of the bulb with
the stem then
4 Shakes it gently by flicking at the wrist till the mercury in the column falls back
into the chamber
5 Removes /exposes the baby’s arm fully
6 Places the silver bulb end of the thermometer under the baby’s arm at the apex
of the axilla, parallel to the lateral wall of the chest of the baby
7 Gently holds the baby’s arm against the body
8 Keeps the thermometer for 5 minutes
9 Removes the thermometer and reads the temperature
10 Records the findings
Informs the mother
11 Cleans the shining tip with cotton spirit, places it in the box
7
CHECKLIST FOR: TEMPERATURE RECORDING

(Using Digital Thermometer)
N
O
1 Takes thermometer out of its storage case, holds at broad end, and cleans the
shinning tip with cotton ball soaked in spirit.
2 Presses the pink button once to turn the thermometer on. “188.8” flashes in the
centre of the display window, then a dash (-), then the last temperature taken
and then three dashes (- - - ) and a flashing “F” in the upper right corner.
3 Holds the thermometer upwards and places the shinning tip under the baby’s
arm at the apex of the axilla, parallel to the lateral wall of the chest of the baby.
4 There will be a beep sound every 4 seconds while the thermometer is recording
the temperature. When she hears 3 short beeps, looks at the display. When “F”
stops flashing and the number stops changing, removes the thermometer.
5 Reads the number in the display window. Records the temperature reading on
the form.
6 Turns the thermometer off by pushing the pink button one time.
7 Cleans the shinning tip of the thermometer with a cotton ball soaked in spirit
and places thermometer back in its storage.
8
CHECKLIST FOR: MAINTAINING TEMPERATURE USING RADIANT

WARMER
N
O
1 Switches on the machine at least 20 minutes prior to the expected time of
delivery/arrival of the LBW or Sick Babies.
2 Identifies in the temperature panel that the readings are set as skin temperature
and the air temperature
3 Identifies servo and manual mode switches
4 Sets warmer in manual mode
5 Adjusts the heat output to:
 HIGH : If baby temperature is below 36 0C
 MEDIUM : If baby temperature is between 36 0C – 36.5 0C
 LOW : : If baby temperature is between 36.5 0C – 37.5 0C
6 Switches to servo control mode setting once the temperature of baby is between
36.5 0 C – 37.40 C
7 Places the baby (Baby Doll) on the bassinet. Identifies the correct site (right
hypochondrium in supine position) and connects skin probe to the baby’s
abdomen with sticking tape.
8 Sets alarm setting. (Set the desired temperature of baby to be maintained
between 36.5 0 C – 37.40 C)
9 Ensures that the baby’s head is covered with cap and feet secured in socks and
the baby is clothed or covered unless it is necessary for the baby to be naked or
partially undressed for observation or for a procedure.
10 Able to respond to alarm immediately, identify the fault and rectify it.
11 Checks the sensor probe regularly so as to ensure that it is in place.
9
CARE OF NEWBORN IN INCUBATOR
Definition
Care of new born in incubator is to regulate the body temperature.
Purpose
To provide thermo neutral environment to full and preterm babies.
General Instruction
 Incubator is to be cleaned daily with soap and water daily

 Assist in doing all the procedure in the incubator including X- ray
 Once the baby is taken out, clean the incubator thoroughly with soap and water and keep ready for
next use.
CHECKLIST FOR CARE OF NEWBORN IN INCUBATOR
SI Step/Task 1 2 3 4 5
NO
1 Keep all the equipment ready

 Isolette
 Air shields
 Incubator
2 Explain the need for incubator to parents
3 Check for doctor’s order
4 Make sure incubator is clean before placing the baby. Apply liquid
10
soap and clean it with dry duster.
5 Switch on incubator for 20 minutes to prewarm and then place the
baby.
6 Adjust incubator and keep it according to the temperature chart
available in the nursery.
7 Check axillary temperature of the baby every hour.
8 Keep the temperature mode to ‘air’ to avoid overheating of the baby.
9 Continue care through portholes.
10 Avoid unnecessary opening of incubator door by planning the care of
the baby.
11 Report to doctor if baby is not maintaining normal temperature for
two consecutive readings.
12 Continue care till baby is removed from the computer.
13 Document
 Time and temperature of the baby
 Set temperature of the incubator
11
CHECKLIST FOR BABY BATH
S.I STEP/TASKS 1 2 3 4 5
No.
1. Arrange the articles
 Mackintosh-1
 Large towel-4
 Small towel-1
 Nappy cloth
 Dress
 Soap in soap dish
( Johnson & Johnson)
 Apron

A. A clean tray containing
 Sterile swabs for eye care and cord care
in a bowl
 Normal saline solution
 Spirit in bottle
 Bowl with cotton swabs
 No absorbent cotton swabs
B. Temperature tray
 Bottle (3)-Disinfectant (2)
-Clean water (1)
 Clinical thermometer
 Cotton swabs in bowl
 Lignocaine jelly
 Kidney tray
C. Jugs (2)
D. Bath basin (2)
E. Bucket (2)
Preparation of baby
2. Check the physician’s orders to see the specific precaution
to be taken
3. Assess the infant’s need for bathing
12
4. Check whether the child has taken feed in the previous one
hour
5. Check the articles available in the unit
6. Check the body temperature
7. Explain the procedure to the mother and let her be with the
nurse
Preparation of the environment

8. Close windows and put off fan to prevent draughts
9. Adjust the position of the bath table
10. Wash hands and wear apron
11. Place the mackintosh and towel on the table
12. Fill the basin half with warm water (37.0 C) .The water
should feel slightly warm to the inside of the wrist or elbow
and keep it over the table
13. Bring the baby covered in a bath blanket to the table
17. Wrap the baby in a big towel arranged on the table. Wrap in
such a way that the hands are restrained in the towel
Procedure
19. Attends to infants face, ears and scalp
 Wipe the eyes from inner canthus to the outer
canthus using separate swab for each eye. Use one
swab for one stroke .Observe for colour of sclera,
discharge etc.
 With the wet hand, clean the face and behind the
ears. Do not apply soap on the face. Dry the face by
patting and not by rubbing
20. Observe the mouth for thrush when baby cries
Use non-absorbent cotton to plug the ears or fold the ears
over the external auditory meatus with thumb and index
finger of one hand to prevent entry of water into the ears
21. Pick up the baby securely by sliding hands until the baby’s
head is well supported by your palm. Hold the baby’s head
over basin, wash baby’s head, apply soap and rinse well
with water and dry the head thoroughly
22. Discard the water and take fresh water
23. Place the baby on the bath table unwrap the baby, wet the
baby with wet hands. Apply soap all over the body, giving
special attention to the neck, axilla, arms, finger, groin and
toes
24. Hold the baby firmly by supporting the head at the neck
between index and the three fingers of the nurse. Submerge
gradually into the water in the tub to rinse the soap
completely
27. To pick up the baby, slide the hands under the baby’s
shoulders and grasp at the chest firmly. The head is
13
supported be the fingers of both hands. Make sure that your
hands are free of soap.
Take the baby from the water and dry him/her by patting
gently, special attention is given to dry the body creases
After care of the baby
29. Thoroughly dry the baby with careful attention to the area
around the cord stump if any
31. Mummify the baby to prevent chills
32. Comb the hair
33. Hand over the baby to the mother to give feed
After care of articles

34. Take the articles to the utility room. Disinfect the towels
and basin
35. Clean and dry them and replace in their proper place
36. Wash hands
37. Recording
Record the procedure in nurses record with date, time,
weight of the baby, temperature, observations and findings
38. Observation
It is to be made for skin infection, oral thrush, cyanosis,
jaundice, cord discharge, respiratory changes
14
CHECKLIST FOR: USE OF SUCTION MACHINE
N
O
1 Connects to the main
2 Switches on the unit
3 Identifies the pressure gauge
4 Occludes the distal end to check the pressure reading
5 Adjusts the pressure knob to keep pressure of suction to 100 cm of water
6 Washes Hands
7 Wears the Gloves
8 Takes disposable suction catheter
9 Connects to suction tubing and performs the suction gently
10 Switches off the suction machine.
15
CHECKLIST FOR: : USE OF SUCTION MACHINE (FOOT/ HAND

OPERATED)
N
O
1 Places the foot suction on floor across and in front of resuscitation trolley, with
bellows on right side (if you use your right foot) and fluid collection jar on left
side.
2 Washes Hands
3 Connects suction catheter to patient end of silicone tubing of machine , Ensures
that suction catheter is placed on baby mattress and tube length is adequate
4 Places right foot on bellows and press down ensuring that it slides down in
contact with the central vertical metal plate. This ensures that bellows do not tilt
outwards, preventing slipping of foot.
5 Pinches the suction catheter end, presses the bellows and checks for suction
pressure. Foot pressure can be adjusted to ensure adequate suction pressure.
16
CHECKLIST FOR: USE OF PHOTOTHERAPY MACHINE FOR

NEWBORNS WITH JAUNDICE
N
O
1 Switches on the phototherapy machine and checks whether all the tubes are
lighting up.
2 Adjusts the height of the phototherapy’s lamp (45 cms & less )
3 Undresses the baby covers eyes with eye pad , covers external genitalia with dry
napkin
4 Places the infant on the basinet
5 Ensures frequent changes of baby position (every 2 hours or after breast feeding)
in order to maintain exposure to all parts.
6 Encourages frequent breast feeding
7 Ensures baby receives continuous phototherapy. However, Temporary
interruptions for breast feeding or procedures are allowed.
8 Monitors baby’s temperature four hourly and weight every 24 hours
9 Estimates serum bilirubin at least once a day as clinical or visual assessment of
jaundice under lights becomes fallacious.
10 Maintains a log book of phototherapy unit usage in hours /checks the time
recorder on equipment and replaces the tube lights as per recommendation
(every 3 months or used more than 1000 hours or if the end of the tubes
blacken/ tubes flicker.
17
CHECKLIST FOR: USE OF GLUCOMETER
N
O
1 Keeps the equipment’s ready for estimating blood sugar – Glucometer,
Glucostrips, Lancets, spirit for skin preparation,
2 Washes hands
3 Prepares the skin puncture site ( Newborn: Postero-lateral aspect of the heel,
Children and adults: Finger tip) by using spirit and allows spirit to dry
4 Inserts the testy strip into glucometer
5 Makes a puncture with lancet and allows a drop of blood to form and drawn into
the reaction zone of the test strip through capillary action.
6 Records the results displayed in the meter display window after 30 seconds
18
CHECKLIST FOR: INSERTING NASOGASTRIC FEEDING TUBE AND FEEDING IN A BABY
NO
Identifies the NG tube of correct size based on the gestational age(6 or 8 Fr) and
1.
leaves the pack partially open
Washes hands, wears gloves, moistens tube with saline
2.
Measures the length from tragus to external nares till midpoint between
3.
umblicus and xiphisternum. Marks the tube at this point.
4. Inserts gently through one nostril till the measured distance is reached.
Confirms the position of the tube
5. - By aspirating gastric contents. If no aspirate is obtained then Pushes 3 ml of air

and auscultates for gurgling sound over stomach with the stethoscope.
If there is any doubt about the location of the tube, withdraw it and insert the
6.
NG tube again.
Fixes the tube firmly over nose or upper lip with plaster.
7.
8. Attach drainage bag, if there is abdominal distention
9. Attach syringe barrel to catheter and pour small amount of feed
10. Elevate 6 to 8" above mattress
11. Use plunger to apply gentle pressure on column of fluid to initiate flow
12. Add more formula before syringe is empty. Allow feed to flow slowly into
stomach. Each feeding has to take 15 to 20 minutes to complete
13.
Pour small amount of water to flush tubing
14. Clamp or cap tube
15. Burp child (below 1year of age) if possible-after feeding
19
16. Position child on right side or abdomen for at least an hour
17.
Record in nurse's record, type and amount of feed,
Amount retained .or regurgitated.
CHECKLIST FOR INSERTION OF OROGASTRIC TUBE IN A BABY
SI NO Steps
1. Identifies the feeding tube of correct size based on the gestational age(6 or
8 Fr)
2. Washes hands, wears gloves, moistens tube with saline
3. Measures the length from angle of mouth to tragus to midpoint between
umblicus and xiphisternum. Marks the tube at this point.
4. Inserts gently through the mouth till the measured distance is introduced.
5. Confirms the position of the tube
- By aspirating gastric contents. If no aspirate is obtained then Pushes 3 ml
of air and auscultates for gurgling sound over stomach with a stethoscope.
6. If there is any doubt about the location of the tube, withdraws it and inserts
the OG tube again.
7. Fixes the tube firmly with tape to the side of the mouth.
8. Attaches drainage bag, if there is abdominal distention
20
CHECKLIST FOR PREPARATION OF SUPPLEMENTARY FEEDING
S.I STEP/TASKS 1 2 3 4 5
No.
1. Assemble equipment
A. Formula room vessel bundle, which
includes
 Big sauce pan
 Steel vessels (2)
 Strainer (1)
 Spoon (1)
 Plate (1)
 Teaspoon ( 1)
 Pint measure (1)
B. Sterile linen bundle with:
 Gowns (2)
 Square sheets (2)
 Hand towels (2)
C. Sterile gloves pairs (2)
D. Kettle with boiled water
E. Steel trays (2)
F. Wire baskets (2)
G. Milk can with milk
H. Sugar container
2. Open gown and vessel bundle

3. Wash hands with soap and water
3. Wear sterile gown and gloves
5. Arrange feeding bottles on the tray
6. Spread square sheet and on the other
tray arrange vessels
7. Prepare sugar water using boiled water (1
teaspoon sugar in 90 ml of water) and label
bottle
8. Prepare milk mixture (1:1) or (2:1) as
required. Add sugar (1 teaspoon sugar in
21
90 ml of water) stir and strain milk, Pour
into bottles. Cover and label
9. Arrange these bottles in a wire basket and
place in a boiler for 10 minutes with ¾ of
bottle immersed in water
10. Take out basket, cool and replace bottles in
refrigerator
11. Replace equipment and leave room clean
and tidy
CHECKLIST FOR: USING PULSE OXIMETER
N
O
1 Connect to Main.
2 Use the mode switches in the oximeter real panel to set the language, averaging
mode,Patient mode, patient’s pulsatile value display and EMI line frequency. If
you change the switch settings while the oximeter is on, the new settings do not
take effect until you power OFF then ON again.
3 Applies probe to the site that is well perfused like finger, toe, pinna or ear lobule.
In Infants foot or palm can also be used.Avoid edematous, bruised sites and
excessive pressure.
4 Ensures probe is in place and both sides of probe are directly opposite each
other
5 Sets high and low alarms for saturation (2% above and below desired limits) and
heart rate 100 to 160 /min
6 Observe and change site at least once per shift
22
CHECKLIST FOR: OXYGEN ADMINISTRATION
N
O
1 Ensures all the parts are available
2 Ensures oxygen cylinder is secured on flat surface in trolley. There is no naked
flame nearby and does not use oil/greese to lubricate the joints
3 Attaches the regulator
4 Attaches flow meter to the regulator to set the flow rate.
Ensures the flow meter is vertical
5 Attaches humidification bottle to the flow meter. Fills clean water up to the mark
level on the bottle. Ensures the humidifier bottle is washed daily with soap and
water and water is changed daily.
6 Attaches an oxygen tube to the humidifier
7 Using a spanner/Key turns on oxygen from the cylinder.sets the desired flow rate
from the flow meter .Ensures there are no leaks.
8 Connects oxygen tube to the nasal prongs/catheter /Face mask/oxygen hood to
deliver oxygen to the patient.
9 Ensures the nose is clear. Places the nasal prongs just inside the nostril.runs the
tubbing under the nostril alongside the childs head and tapes it ,adjusts the
oxygen flow rate- 0.5 to 1 lit per minute for children less than 2 months and 1 – 2
lit per minutes for children 2 months upto 5 yrs
23
CHECKLIST FOR: OXYGEN CONCENTRATOR
N
O
1 Plugs in the power supply cable
2 Switches on the concentrator. once the concentrator is on a yellow light will
come up
3 Checks the distilled water level in humidifying jar and ensures that it is up to the
marking
4 Adjusts the oxygen flow as per observers’ demand (3 – 4 liters).The yellow light
will be on till the desired concentration of oxygen is achieved.
5 Fixes the nasal prongs inside the baby’s nostril and fixes it with a tape or Fixes
face mask –ensuring that it get fixed snuggly covering the baby’s mouth, nose
and chin.
6 Aware of Flow-splitter device connected to the outlet which provides oxygen to
four patients at the same time by setting up four different nozzles. If less number
of patients are receiving oxygen unused outlets are closed.
7 Ensures that there are no air leaks. Makes sure the nose of the patient is clear
8 If pulse oximeter is available, monitors SPO2
24
CHECKLIST FOR: USING NEBULIZER AND MULTI DOSE INHALER
N
O
1 Removes the cap from the inhaler and shakes the inhaler well
2 Asks the patient to take a few deep breaths and then breathe out gently
3 Asks the patient to immediately place the mouthpiece inside the mouth with lips
forming a seal
4 Instructs the patient to press the inhaler and at the same time begin a slow, deep
breath and Continue to breathe in slowly and deeply over 3 - 5 seconds. Hold the
breath for up to 10 seconds and then resume normal breathing
5 Advises to repeat the above steps when more than one puff is prescribed
6 Advises to wait 1 minute between actuations; this may improve penetration of
the second actuation into lung airways
7 Asks the patient to recap the MDI
25
CHECKLIST FOR: USING MULTI DOSE INHALER WITH SPACER

N
O
1 Removes the cap from the inhaler and shakes the inhaler well
2 Attaches the mask to the mouthpiece of the spacer
3 Inserts the inhaler mouthpiece into the hole in the end of the spacer (the inhaler
should fit snugly and without difficulty)
4 Places the mask over the child's nose and mouth so that it makes a seal with the
face
5 Presses down on the inhaler canister to spray one puff of medicine into the
spacer
6 Holds the mask in place and allows the child to breathe in and out slowly for five
breaths
7 If child needs to give another dose, waits 30 seconds, shake the inhaler again
then repeats steps 4 to 7
26
CHECKLIST FOR: NEBULIZER
N
O
1 Washes hands thoroughly before you using a nebulizer and makes sure the
equipment is clean
2 Measures and puts the correct dosage of medication to be administered into
the nebulizer chamber (cup) and adds saline solution to make the volume 3-5
ml. If the medicine is in single-use vials, twists the top off the plastic vial and
squeeze the contents into the nebulizer cup
3 Connect the mouthpiece, or mask, to the T-shaped elbow ( face mask for smaller
children and mouthpiece for older children)
4 Connects the nebulizer tubing to the port on the compressor. Turns the
compressor on and checks the nebulizer for misting
5 Holds the nebulizer in upright position to avoid spillage. If using mask ensures it
is fitting well. In older children asks the patient to keep the mouthpiece inside
the mouth and close lips around it
6 Asks the patient to take slow deep breaths and if possible hold the breath for up
to 10 seconds before exhaling. Occasionally taps the side of the nebulizer to help
the solution drop to where it can be misted
7 Continues nebulization until the medicine is gone from the cup (10 minutes)
27
CHECKLIST FOR: PREPARATION AND USE OF ORS

N
O
1 Washes hands with soap & water
2 Empties the content of 1 lit ORS packet into a clean container. Ensures no
powder is left in the packet.
3 Measures one lit of clean drinking water using a measuring jar or one lit plastic
bottle.
4 Pours the measured one lit water in to the container with continuously stirring
so that whole powder is dissolved.
5 Tastes the prepared ORS solution to ensure it has been prepared correctly.
6 Keeps the container covered. And remembers to use prepared ORS solution upto
24 Hours only.
7 Ask the mother to give ORS by cup & spoon in her presence.
28
CHECKLIST FOR: ADMINISTRATION OF ZINC TABLET
N
O
1 Washes hands with soap and water
2 Takes a clean spoon and places half tablet of Zinc for child 2 months up to 6
months and 1 tablet for a child 6 months up to 5 years
3 Pours mothers breast milk or clean water in the spoon.
4 Allows the tablet to disperse (30 seconds to 1 minute).Checks that the tablet is
completely dissolved.
5 Asks the mother to give the prepared Medicine to the baby in her presence. If
some portion of the medicine is left in the spoon puts little breast milk or water
and give to the child
29
CHECKLIST FOR ADMINISTRATION OF BCG VACCINE
NO
1. Keeps the necessary items ready , Vaccine carrier with BCG vaccine and diluent
(normal saline ) , 5 ml mixing syringe , BCG syringe(0.1 ml AD syringe) , cotton , Hub
cutter , immunisation card
2. Checks
• Whether it is the right vaccine and diluent;
• the vaccine has not passed its expiry date and VVM is in usable stage
3. Opens an ampoule of diluent and draws 1ml of diluent into a fresh sterile mixing
syringe
4. Inserts the mixing needle into vial of vaccine and empties the diluent in it and
withdraws the syringe
5. Cut the hub of mixing syringe with hub cutter , discards plastic part of the syringe in
red bag.
6. Mix the vaccine and diluent by gently shaking the vial with one hand . write the time
and date of reconstitution on label.
7. Ask the parent, to seat the child on her lap, and hold the child firmly. Baby’s head
rests on mother’s left arm . Baby’s left arm and legs are controlled by mother’s right
arm and hand.
8. Open a fresh 0.1 ml AD syringe and throws syringe wrapper and cap in black bag.
Load the BCG syringe with reconstituted BCG vaccine with dose of 0.05 ml.
30
9. Positions left hand under child’s left arm and gently pulls the skin under the arm to
stretch the skin at injection site
10. Hold the syringe in right hand, with the bevel of the needle facing up. Lays the
syringe and needle almost flat (at an angle of 15 degrees) along the child's arm.
11. Puts left thumb over needle end of syringe (not on the needle ) to hold it in position
12. Holds the plunger between index and middle finger of right hand and press plunger
with right thumb.
13. Injects vaccine and withdraws the needle
14. Looks for clear, flat-topped swelling on the skin (bleb) .
15. Cuts the hub of syringe with hub cutter and puts the plastic part in red bag.
16. Documents in immunisation card and give 4 key messages about immunisation.
 Which vaccine was given and which disease does the vaccine protects against
 When to come for next vaccination
 Effects and side effects of immunisation and how to manage the same: after
2-3 weeks a papule develops which increases slowly in size upto 5 weeks (4-
8mm) . It will then subside and break into a shallow ulcer, healing will occur in
4-8 weeks , following a permanent scar.
 Keeping immunisation card safe and bringing it on next visit.
CHECKLIST FOR ADMINISTRATION OF DPT VACCINE

NO
1. Keeps necessary items ready : vaccine carrier, hub cutter, cotton , 0.5 ml AD syringe ,
immunisation card
2. Checks the clarity of the solution and expiry date on the vaccine vial to make sure
vaccine is in usable stage
3. Shakes the vial to observe freezing or floccules or particulate matter . Discards the
vial, if present
4. Position the child on the mother’s lap, in such a way that the child’s head rests in
mothers llap in it arm with right arm of the child placed at the back of mother .
With the right hand mother holds the child’s left arm and restraints both legs over
knees using her right hand
Loads the vaccine into syringe
6. Expels excess air from syringe by tapping it and makes sure that syringe has exactly
0.5 ml of vaccine
7. Positions herself on left side of the mother divides the infants thigh into three
segments drawing imaginary line and selects middle segment Puts finger and thumb
of left hand on the anterio lateral side)
8. Stretches the skin flat between finger and thumb
31
9. Hold the syringe like a pen in the right hand the needle pointed towards knee at
45degrees
10. Press the top of the plunger with the thumb to inject the vaccine.
11. Withdraw the needle and press the site of injection with a dry cotton swab.
12. Cut the needle with the hub cutter and put the plastic part of the syringe into the red
bag.
13. Documents in immunisation card and gives 4 key messages about immunisation.
 Effects of immunization like Localised redness and swelling at injection
site ,Low-grade fever, drowsiness or tiredness
 and how to manage the same : Giving paracetamol syrup for fever , cold
cloth at injection site for local swelling , extra fluids
 As a routine crocin syrup is given, specific instruction can be put related to
giving syrup/ drops
CHECKLIST FOR ADMINISTRATION OF TT VACCINE
NO
1. Keeps the necessary items ready : Vaccine carrier with TT vaccine , cotton , 0.5ml AD
syringe , hub cutter, immunisation card
2. Explain what vaccine will be given and the disease it prevents
3. Checks the expiry date on the vaccine vial to make sure vaccine is in usable stage
4. Shakes the vial to rule out freezing or floccules
5. Notes down the batch number of the vaccine
6. Loads the vaccine in a 0.5ml AD syringe , throws AD Syringe wrapper and plastic cap
in black bag
7. Expel excess air from the syringe by tapping the syringe
8. Puts the finger and thumb of left hand on either side of injection site (upper arm)
Please add a sentence on selection of site i.e., deltoid muscle( locate the acromian
process put four fingers below using her left hand )
10. Holds the syringe like a pen in right hand and inserts the needle at 90 degrees ,
through skin between finger and thumb
32
11. Press the top of the plunger with the thumb to inject the vaccine
12. Withdraws the needle and presses the site of injection with a dry cotton swab
13. Cuts the hub of the syringe with hub cutter and puts the plastic part on the syringe in
red bag
 Effects and side effects of immunisation and how to manage the same
CHECKLIST FOR ADMINISTRATION OF MEASLES VACCINE

NO
1. Keeps the necessary items ready ,
Vaccine carrier with measles vaccine and diluent ( pyrogen free double distilled
water ), 5 ml mixing syringe , cotton swab , 0.5 ml AD syringe , hub cutter,
immunisation card TT vaccine , cotton
2. Checks
• Whether it is the right vaccine and diluent;
• the vaccine has not passed its expiry date and VVM is in usable stage
3. Opens an ampoule of diluent and draws 1ml of diluent into a fresh sterile mixing
syringe
4. Inserts the mixing needle into vial of vaccine and empties the diluent in it and
withdraws the syringe
5. Cut the hub of mixing syringe with hub cutter , discards plastic part of the syringe in
red bag.
6. Mix the vaccine and diluent by gently shaking the vial with one hand . write the time
and date of reconstitution on label.
7. Ask the mother, to seat the child on her lap, and hold the child firmly. The mother’s
right arm should be around the child, supporting her head.
• The child's left arm should be tucked around the parent's body at the back.
33
• The mother’s right hand should hold the child's right arm and mother’s left leg
would cross over both the legs of the infant .
8. Opens a fresh 0.5 ml AD syringe and throws syringe wrapper and cap in black bag.
Load the syringe with reconstituted measles vaccine with dose of 0.5 ml.
9. Expels excess air from the syringe by finger tapping the syringe
10. Pinches the skin of right upper arm of baby through left index finger and thumb
11. Inserts the needle in a slanting position at 45 degrees angle into the pinched up skin
using caution not to push the needle too far in
12. Presses the plunger with thumb to inject the vaccine
14. Cut the needle with the Hub cutter and put the plastic part of the syringe into the red
bag.
 Effects a of immunisation like Fever , Mild rash
 and how to manage the same by giving paracetamol syrup, extra fluids, lose
clothing
Add Quest. On how long the reconstituted vaccine can be kept? In few cases mild
measeles illness may occur, what is the nature of such an illness , and how many days
the illness may persist?
CHECKLIST FOR ADMINISTRATION OF ORAL POLIO VACCINE

NO
1. Keeps the necessary items ready , vaccine carrier with OPV
2. Check VVM on the vial and the expiry date before use. Discards the vaccine if the
inner square is darker or has the same colour as the outer circle .
3. Opens the dropper bottle by removing the cap and put the bottle on the foam in
vaccine carrier to keep it cold.
4. secures the dropper cap on the open vial.
5. Ask the mother to hold the child firmly, with the child lying on his back in her lap.
6. Open the child's mouth by stimulating the circumoral area using her little finger this
makes the child's open mouth .
7. Hold the dropper over the child's mouth at an angle of 45°. squeeze two drops of
vaccine from the dropper on to the child's tongue.
8. Make sure the child swallows the vaccine. If it is spit out, give another dose.This step
can be deleted as 6 weeks baby will swallow without spitting
9. Put two drops directly in the mouth of the child. Take care that the dropper does not
touch the mouth.
34
Put the dropper and vial on the foam in a vaccine carrier to keep them cold.
10.
 Effects and side effects of immunisation and how to manage the same
CHECKLIST FOR ADMINISTRATION OF HEPATITIS VACCINE

NO
1. Keeps necessary items ready : vaccine carrier, hub cutter, cotton , 0.5 ml AD syringe ,
immunisation card
2. Checks the expiry date on the vaccine vial to make sure vaccine is in usable stage
3. Shakes the vial to observe freezing or floccules or particulate matter . Discards the
vial if present
4. Position the child on the mother’s lap, in such a way that the child’s head rests on
mother’s right arm with left arm of the child placed at the back of mother and
mothers right hand holds child right hand. With the left hand mother holds the
child’s both legs
Loads the vaccine into syringe
6. Expels excess air from syringe by tapping it and makes sure that syringe has exactly
0.5 ml of vaccine
7. Puts finger and thumb of left hand on either side of the injection site ( right
anterolateral thigh )
35
9. Hold the syringe like a pen in the right hand and push the needle straight down at
90degrees
10. Press the top of the plunger with the thumb to inject the vaccine.
12. Cut the needle with the hub cutter and put the plastic part of the syringe into the red
bag.
 Effects of immunization like localised pain, redness , swelling at injection
site, injection site nodule, Low-grade fever
 and how to manage the same by giving paracetamol for fever, cold cloth at
injection site for local reaction
 Keeping immunization card safe and bringing it on next visit.
CHECKLIST FOR INJECTION SAFETY MEASURES

NO
1 Washes her hands before preparing an injection with soap and running water
2 Keeps the injection prepared on a visibly clean, dedicated table or tray where
contamination of the equipment with blood, body fluids or dirty swabs is not present.
3 Uses the standard disposable syringe for injection and needle taken from a sterile
unopened packet or fitted with caps.
4 For reconstitution, a syringe and needle each taken from a sterile unopened packet or
fitted with caps.
5 Uses reconstitution of powdered vaccine or medicine performed made from the
diluent provided by the manufacturer.
6 Uses a new pair of gloves for every procedure.
7 Cleans the patient’s skin with an antiseptic solution before giving the injection.
8 Uses the right technique to give the injection as per the guidelines.
9 Follows “No Recapping” and uses a hub cutter or needle destroyer to disposes off the
36
needle
10 Disposes the syringe in red colour coded container
CHECKLIST FOR REVERSE SPIRAL BANDAGING

NO
1. Explains the purpose of spiral bandaging to the patient
2. Takes permission from client
3. Sets the tray
4. Collects the tray near the client
5. Anchors at wrist with primary turns
6. Brings bandage obliquely up forearm to just below the elbow
7. Makes a circular turn
8. Bring obliquely downward to wrist and circle wrist
9. Checks whether it’s not too loose or too tight
10. Starts the bandage obliquely upward again
11. Folds the bandage back and hold fold with thumb
37
12. Continue around arm and repeat procedure until arm is covered
13. Each turn must overlie about two thirds of preceding turn and reverse must be in
straight line
14. Secures the bandage by tucking just under elbow
15. Replaces the article
16. Records the procedure in nurses’ notes
17. Asks and observes for any discomfort
CHECKLIST FOR FIGURE OF EIGHT BANDAGING

NO
1. Explains the purpose of bandaging to the patient
3. Sets the tray
5. Carry spirally upward around the forearm
6. Apply circular turn just below the elbow
7. Checks whether it’s too lose or too tight
8. Then carry spirally downward around forearm forming X upward turn and repeats
procedure
9. Each turns overlapping one half or two thirds of proceeding turns
10. When forearm is covered , secures the bandage below elbow by tucking
38
CHECKLIST FOR SPIRAL BANDAGING

NO
1. Explains the purpose of bandaging to the patient
3. Sets the tray
5. Anchors around foot near base of toes , carries obliquely across instep and around
the heel
6. Continue obliquely around instep , crossing preceding turns to the base of large toe
7. Apply succeeding spiral turns up the heel just above the ankle
8. With each turn , overlaps one third of previous turns
9. Checks whether it is not too loose or too tight
39
10. Secures the bandage by tucking just above the ankle
CHECKLIST FOR CARE OF THE CHILD IN PLASTER CAST

Sl. no Step/task 1 2 3 4 5
1. Identify the child
2. Greet the child and the family members
3. Introduce self and the procedure to be performed
4. Check for the circulatory, neurological integrity around the cast already
applied.
A) Paleness,
B) Cyanosis
C) Unusual coldness
D) Mottled appearance
E) Tingling or numbness
F) Pain or burning sensation
G) Weak or absent peripheral pulse
H) Ability to move toes of fingers
5. Check for any sign of infection or swelling around the cast
6. Assess for the tightness of the cast by inserting finger between the skin
and the cast (after it is dried well)
40
7. Assess the child’s respiratory rate and depth, color and behaviour are
assessed
8. Assess the vitals of the patient.
9. Trim the rough edges of the plaster.
10. Provide required padding
11. Inspect the cast again for any small objects beneath the cast and any hot
spot.
12. Check for the dryness of the cast. If not dry allow adequate position
change to dry it.
13. Check for the color and cleanliness of the cast if not clean or soiled apply
white shoe polish to clean it and dry.
14. Provide active and passive exercises, it the child is in body spica, or in
hip spics he/she should be turned routinely.
15. Support the uncasted areas of the body with pillows.
16. Instruct the child and the parents not to include inserting any object on
using lotion or powder on the skin beneath the cast.
17. Teach the parents how to care for the child in a cast and sign and
symptoms of the circulatory and neuro sensory impairment and infection.
LUMBAR PUNCTURE
Definition:
Insertion of a needle into lumbar area of sub-arachnoid space to withdraw CSF for diagnostic and
therapeutic purposes. The most common lumbar puncture site is usually lower for infants and small
children, whose spinal cord extends into the sacral region.
Purpose:
 Obtain CSF for examination ( microbiological ,serological, cytological or chemical analysis)

 Relieve CSF pressure
 To analyse the constituents of CSF
 Introduce medication, air or radio –opaque contrast material into sub- arachnoid space.
 Administer ,spiral anesthesia before surgery
 Measure the pressure of CSF
41
Preliminary assessment
 Assess the history and physical findings for the signs of increased intra cranial pressure or altered
level of consciousness
 Assess the age ,developmental level and coping strategies of the child
 Assess the family’s knowledge regarding the test outcomes and potential complications
Preparation of the articles
 Sterile tray
 Sterile lumbar puncture set – articles to be listed
 Sterile gloves , gown and mask
 Sterile dressing towels with slit
 Sterile cotton swabs , guaze pieces, cotton pads
 Lumbar puncture needles 2 sizes with stillette
 5 ml syringe , with needles to give local anesthesia
 Sponge holding forceps
 Small bowel to take antiseptic solution
 Specimen bottles
Clean tray containing
 Adhesive plasters and scissors

 Mackintosh and towel kidney tray and paper bag
 Lignocaine
 Skin antiseptics and sterile normal saline
CHECKLIST FOR LUMBAR PUNCTURE

S.I STEP/ TASK 1 2 3 4 5
No.
1. Explain the procedure to the family and to the child.
Arrange all the articles
2.  Sterile tray
1.  Sterile lumbar puncture set – articles to be listed
 Sterile gloves , gown and mask
 Sterile dressing towels with slit
 Sterile cotton swabs , guaze pieces, cotton pads
 Lumbar puncture needles 2 sizes with stillette
 5 ml syringe , with needles to give local anesthesia
 Sponge holding forceps
 Small bowel to take antiseptic solution
 Specimen bottles
Clean tray containing
 Adhesive plasters and scissors
42
 Mackintosh and towel kidney tray and paper bag

 Lignocaine
 Skin antiseptics and sterile normal saline
3. Position the child

Recumbent position
Restrain the patient by directing one arm under the flexed knees
and grasping the child’s wrists. This restrains both the upper and
lower extremities. The other arm is placed posteriorly around the
patients neck and shoulders.
Sitting position
The child may sit voluntarily on the table with elbows resting on
the knees and back arched. A pillow can be placed in front of the
chest and the child instructed to grasp it. The nurse must hold the
infant in a sitting position. By flexing the thighs on the abdomen
the nurse is able to grasp the elbow and knees in both hands thus
flexing the spine in the appropriate angle.
Assist the doctor as required – The doctor will proceed as
follows
4. Wash the hands

5. Puts the gloves
6. Prepare the skin with antiseptic solution
7. Drapes the back and identify puncture site.
8. Infiltrates the areas with local anesthetic agents
9. Insert the needle and stillet firmly into the sub arachnoid space
10. When the samples are collected and measurement completed the
needle is withdrawn
11. Apply pressure ,over the lumbar puncture site using a sterile
topical swab.
12. Dorsal recumbent position of 8 to 24 hrs
13. Record the procedure with time, date, appearance of the spinal
fluid ,condition of child, label and send to the lab
14. When the leakage from the puncture site has ceased , apply a
plaster dressing over the site.
15. Observe patient for next 24 hrs
 Leakage of CSF
 Headache ,backache
 Neurological observations
 Vital signs
After care of child and articles
 Administer prescribed analgesics , if needed

 Continue to observe the child for complications like tachycardia, bradycardia, hypertention of
brainstem herniation , decreased responsiveness , penetration of a nerve etc.
 Keep the child lying flat for 8 to 24 hrs after the procedure
43
 Monitor vital signs , level of consciousness and motor activity every 15 minutes, for 5 hours and
every 30 minutes or another 1 hour
 Wash and replace all the articles
 Advice strict bed rest till the vital signs stabilize
Contraindications
 Intracranial space occupying lesion

 Rectal or abdominal surgery
 Clotting disorder
 Infected skin site
CHECKLIST FOR ESSENTIAL NEWBORN CARE
S.NO Task 1 2 3 4 5
1. Call out the time of birth
Deliver the baby on a warm clean towel on the mothers abdomen

2.
or chest
3. Immediately dry the baby with a warm clean towel
4. Remove the wet towel and wrap the baby in a warm dry towel.
Wipe both the eyes separately with sterile gauze from medial to
5.
lateral side.
6. Clamp and cut the umbilical cord in 1-3 minutes
7. Place an identity label on the baby.

Leave the baby in between the mothers breast to initiate skin to
8.
skin care
Cover the baby’s head with a cap and cover the mother and baby
9.
with a warm cloth
44
10. Encourage initiation of breast feeding
CHECKLIST FOR NEWBORN RESUSCITATION

S.NO Task 1 2 3 4 5
1. Getting ready with :

 Bag and mask
 Suction equipment
 Radiant warmer or other heat source
 2 warm towels
 Clock with seconds hand
 Oxygen source
 Gloves
 Shoulder roll
 Cord tie
 Scissor
2.
Look for meconium and suck mouth and nose at the mother’s abdomen
45
3.
Dry the baby, remove wet towel and wrap in warm dry towel
4. Assess breathing
5. Cut the cord immediately
6. Place the baby on a warm, firm flat surface
7. Position the baby in slight neck extension using a shoulder roll

Suction of mouth and nose
Stimulate the baby
Reposition and reassess breathing
8. If not breathing provide bag and mask ventilation for 30 seconds, make sure
that the chest rises.
9. Reassess the baby after 30 seconds of ventilation.
10. If still not breathing continue bag and mask ventilation, start oxygen and
assess the heart rate.
11. If the baby is still not breathing, continue bag and mask ventilation and refer
to higher center
12. At any point if baby starts breathing , provide observational care
CHECKLIST ON EXAMINATION OF NEWBORN
Look at Look for

RESPIRATORY • Respiratory rate consistently more than 60 or less than
RATE 30 breaths per minute
The normal respiratory rate of a newborn baby is • Grunting on expiration
30 to 60 breaths per minute with no chest • Chest indrawing
indrawing or grunting on expiration • Apnoea (spontaneous cessation of breathing for more
than 20 seconds)
COLOUR Pallor
Babies born at term appear paler than preterm Jaundice (yellow)
babies because their skin is thicker.
Central cyanosis (blue tongue and lips; note that blue
skin in addition to blue tongue and lips indicates a very
serious problem)
HEART RATE (as determined using a • Heart rate consistently more than 160 or less than 100
stethoscope) beats per minute
The normal heart rate of a newborn baby is 100
to 160 beats per minute, but it is not uncommon
for the heart rate to be more than 160 beats per
minute for short periods of time
during the first few days of life, especially if the
baby is distressed. If unsure of the heart rate,
repeat the count.
46
BODY • Less than 36.5 °C
TEMPERATURE • More than 37.5 °C
POSTURE AND • Opisthotonos (extreme hyperextension of the body,
MOVEMENTS with the head
(observed or history of) The normal resting and heels bent backward and the body arched forward)
posture of a term newborn baby includes loosely • Irregular, jerky movements of the body, limbs, or face
clenched fists and (convulsion or spasm)
flexed arms, hips, and knees (Fig. F-1B, page F- Jitteriness (rapid and repetitive movements that are
23). The limbs may be extended in small babies caused by sudden handling of the baby or loud noises
(less than 2.5 kg at birth or born before 37 weeks and can be stopped by cuddling, feeding, or flexing a
gestation;
limb)
MUSCLE TONE • Lethargy (decreased level of consciousness from which
AND LEVEL OF the baby
ALERTNESS can be roused only with difficulty)
• Floppiness (weak muscle tone; limbs fall loosely when
picked up
and released)
• Irritability (abnormally sensitive to stimuli; cries
frequently and
excessively with little observable cause)
• Drowsiness (sluggish)
• Reduced activity
Unconscious (profound sleep; unresponsive to stimuli;
no reaction to
painful procedures)
LIMBS • Abnormal position and movement of limbs
• Baby’s arms or legs move asymmetrically
• Baby cries when a leg, arm, or shoulder is touched or
moved
• Bone is displaced from its normal position
Club foot (foot is twisted out of shape or position; e.g.
heel is turned inward or outward from the midline of the
leg)
• Extra finger(s) or toe(s)
SKIN • Redness or swelling of skin or soft tissues
Some skin conditions are common and should not • Pustules or blisters
cause concern as long as the baby is otherwise • Blistering skin rash on palms and soles
normal.e.g. Milia, erythema toxicum
• Cut or abrasion
• Bruise (bluish discolouration without a break in the
skin, usually seen on the presenting part, e.g. buttocks in
breech presentation)
• Birth mark or skin tag (abnormal spot, mark, or raised
area of the skin)
• Loss of elasticity
• Thrush (bright red patches on skin in napkin area on
buttocks, often scaly in appearance or with small white
centres)
UMBILICUSThe normal umbilicus is bluish- • Umbilicus is red, swollen, draining pus, or foul
white in colour on day 1. It then begins to dry and smelling
shrink • Skin around umbilicus is red and hardened
and falls off after 7 to 10 days.
• Bleeding from umbilicus

EYES • Pus draining from eye
• Red or swollen eyelids
• Subconjunctival bleeding (bright red spot under the
conjunctiva of one or
both eyes)
HEAD AND FACE • Hydrocephalus (large head with bulging fontanelle and
The normal newborn baby’s head may be widened
moulded from a vertex birth; this will resolve sutures)
spontaneously over a period of three to four Bulging anterior fontanelle
47
weeks • Sunken fontanelle
• Unable to wrinkle forehead or close eye on one side;
angle of mouth pulled to one side (facial paralysis)
• Unable to breastfeed without dribbling milk
MOUTH AND • Cleft lip (split in lip)
NOSE • Cleft palate (hole in upper palate connecting mouth and
nasal passages)
• Thrush (thick white patches on tongue or inside mouth)
• Central cyanosis (blue tongue and lips)
• Profuse nasal discharge (“snuffles”)
• Dry tongue and mucous membranes
ABDOMEN AND BACK • Abdominal distension
• Gastroschisis/ omphalocoele (defect of abdominal wall
or umbilicus through which bowel or other abdominal
organs may protrude)
• Spina bifida/ myelomeningocoele (defect in back
through
which the meninges and/or spinal cord may protrude)
WEIGHT • Birth weight less than 2.5 kg
• Birth weight more than 4.0 kg
• Not gaining weight (proven or suspected)
URINE AND STOOL • Passes urine less than six times per day after day 2
It is normal for a baby to have six to eight watery • Diarrhoea (increased frequency of loose stools as
stools per day. Vaginal bleeding in the female observed or reported by the mother; stool is watery or
newborn baby may occur for a few days during
green, or contains mucus or blood)
the first week of life and is not a sign of a
problem. • Has not passed meconium within 24 hours after birth
Sl.N Tasks 1 2 3 4 5
o
1 Assess the victim for a response. If no response, shout for help
2 If someone responds, send that person to activate the emergency response
system and get an AED(If available)
3 Open the victim’s airway and assess the victim’s breathing. Check for
responsiveness (Take at least 5 seconds and no more than 10 seconds).
4 Start chest compressions at the rate of 100 compressions per minute. Compress
at least one third of the anterior-posterior diameter of the chest. Allow for recoil.
5 Open airway and give2 rescue breaths. Look for chest rise.
6 Perform 5 cycles of compressions and ventilations (30:2 ratio).
7 After 5 cycles of CPR:
 If someone has not done this, activate the emergency response system
and get an AED if available.
 Use the AED
8 Continue with cycles of 30 compressions to 2 ventilations until emergency
48
response rescuers arrive or the victim starts breathing spontaneously.
49

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SL. NO. TOPIC PAGE NO.

CHECKLIST FOR HAND WASHING

2. Wet hands in clean running water. Applies soap.

CHECKLIST FOR PUTTING ON AND REMOVING OF HLD/STERILE GLOVES

CHECKLIST FOR WEIGHING OF NEWBORN

11. Gives the baby to the mother

CHECKLIST FOR WEIGHING OF NEWBORN-USING COLOR CODED

CHECKLIST FOR: TEMPERATURE RECORDING

CHECKLIST FOR: TEMPERATURE RECORDING

CHECKLIST FOR: MAINTAINING TEMPERATURE USING RADIANT

CARE OF NEWBORN IN INCUBATOR

Care of new born in incubator is to regulate the body temperature.

To provide thermo neutral environment to full and preterm babies.

 Incubator is to be cleaned daily with soap and water daily

CHECKLIST FOR CARE OF NEWBORN IN INCUBATOR

1 Keep all the equipment ready

CHECKLIST FOR BABY BATH

Preparation of the environment

After care of articles

CHECKLIST FOR: USE OF SUCTION MACHINE

CHECKLIST FOR: : USE OF SUCTION MACHINE (FOOT/ HAND

CHECKLIST FOR: USE OF PHOTOTHERAPY MACHINE FOR

CHECKLIST FOR: USE OF GLUCOMETER

CHECKLIST FOR: INSERTING NASOGASTRIC FEEDING TUBE AND FEEDING IN A BABY

5. - By aspirating gastric contents. If no aspirate is obtained then Pushes 3 ml of air

10. Elevate 6 to 8" above mattress

14. Clamp or cap tube

15. Burp child (below 1year of age) if possible-after feeding

CHECKLIST FOR INSERTION OF OROGASTRIC TUBE IN A BABY

CHECKLIST FOR PREPARATION OF SUPPLEMENTARY FEEDING

2. Open gown and vessel bundle

CHECKLIST FOR: USING PULSE OXIMETER

CHECKLIST FOR: OXYGEN ADMINISTRATION

CHECKLIST FOR: OXYGEN CONCENTRATOR

CHECKLIST FOR: USING NEBULIZER AND MULTI DOSE INHALER

CHECKLIST FOR: USING MULTI DOSE INHALER WITH SPACER

CHECKLIST FOR: NEBULIZER

CHECKLIST FOR: PREPARATION AND USE OF ORS

CHECKLIST FOR: ADMINISTRATION OF ZINC TABLET

CHECKLIST FOR ADMINISTRATION OF BCG VACCINE

CHECKLIST FOR ADMINISTRATION OF DPT VACCINE

CHECKLIST FOR ADMINISTRATION OF TT VACCINE

CHECKLIST FOR ADMINISTRATION OF MEASLES VACCINE

CHECKLIST FOR ADMINISTRATION OF ORAL POLIO VACCINE

CHECKLIST FOR ADMINISTRATION OF HEPATITIS VACCINE

CHECKLIST FOR INJECTION SAFETY MEASURES

CHECKLIST FOR REVERSE SPIRAL BANDAGING

CHECKLIST FOR FIGURE OF EIGHT BANDAGING

CHECKLIST FOR SPIRAL BANDAGING

CHECKLIST FOR CARE OF THE CHILD IN PLASTER CAST

 Obtain CSF for examination ( microbiological ,serological, cytological or chemical analysis)

Preparation of the articles

Clean tray containing

 Adhesive plasters and scissors

CHECKLIST FOR LUMBAR PUNCTURE

 Mackintosh and towel kidney tray and paper bag

3. Position the child

4. Wash the hands

After care of child and articles

 Administer prescribed analgesics , if needed

 Intracranial space occupying lesion

CHECKLIST FOR ESSENTIAL NEWBORN CARE