DELIVERY ROOM PROCEDURES (return demo)

ASSIST HANDLE

• Introduce yourself to the CI. • Introduce yourself to the CI.

• Prepare the DR pack and accessories. • Prepare the DR pack and accessories.

• Get add ons such as cord clamp, ATR • Prepare methergin/oxytocin.

and 5 cc syringe for local anesthesia.

• Assist in positioning patient in the • Assist in positioning patient in the delivery

delivery table into a lithotomy position. table into a lithotomy position.

- To provide the doctor with good access - To provide the doctor with good access to
to the mother and the baby. the mother and the baby.

• Prepare the patient for perineal washing. • Perineal washing with tap h2o.

• Hand washing - donning of PPE - Open • Hand washing - donning of PPE - Open
gloving technique aseptically. gloving technique aseptically.

- To prevent cross contamination. The - To prevent cross contamination. The nurse

nurse should not be the source of should not be the source of infection.
infection. Remember not to touch the Remember not to touch the sterile part of
sterile part of the gloves! the gloves!

• Arrange everything in the preparation • Arrange preparation table.

table.

- In order to pass it immediately to the

doctor, and it saves time. 2 Kelly Curve,
Mayo Scissors, Tissue Forcep, Needle
Holder, Suture, Cord Clamp. 10 cc
syringe.

• Draping of buttocks, leggings (optional), • Draping of buttocks, leggings (optional),

and abdomen. and abdomen.

• Wait for crowning and prepare to support • Assess mother’s VS and baby’s FHR while
the perineum. If EPISIOTOMY IS waiting for crowning.
ADVISED, ASSIST FIRST IN PASSING
THE EQUIPMENTS NEEDED.
- to prevent laceration, support it until CROWNING NOTED
baby’s whole body is out.

• THE ASSIST IS SUPPORTING THE
PERINEUM DURING THIS PART.
• Assist in placental delivery.
- massage the fundus while taking out the
placenta for an effective placental
delivery. THEN CHECK FOR
COMPLETENESS.
• Assist in EPISIORRHAPY.
• Perineal care using betadine antiseptic.
- for infection prevention.
• AFTER CARE - PATIENT, AREA, AND
INSTRUMENTS.
• Assist the OB/midwife during the ED-FIRE-
ERE maneuver.
- Engagement, Descent, Flexion, Internal
rotation, Extension, External rotation, and
Expulsion.
• Take note of the time of delivery.
• Do unang yakap newborn care.
- to provide warmth to the new born.
• While waiting for UC pulsations to stop,
check mother’s VS.
• Clamping and cutting of the umbilical cord
only when pulsations stop.
- this prevents anemia and brain
hemorrhage to premature babies.
• Bring the baby to the radiant warmer and
endorsed to cord dresser. Or while the
baby is in the mother’s abdomen, assist
cord dresser in cutting the cord.
• Monitor signs of placental expulsion and
note time for placenta out. ALSO,
CHECK FOR ITS COMPLETENESS.
- Lengthening of the cord, sudden gush of
blood, change shape of the uterus, firm
contraction of uterus, appearance of the
placenta at the vaginal opening.
• After delivery of placenta, check mother’s
BP.
• Give OXYTOCIN IM per routine care.
• Breast care/latched on.
• AFTER CARE - PATIENT AND AREA.
 CORD DRESS

• Introduce yourself to the CI. • Do anthropometric measurements

(HC,CC, AC, Length)
• Prepare the cord dressing area/radiant
- Head circumference (33-35)
warmer
- Chest Circumference (30-35)
• Secure the things needed - Ask for two
baby's bonnet, layette and diaper. - Abdomen
Mother’s needs - adult diaper, maternity
napkin, underwear, and a dress. - Length
- To assess growth and iden fy nutri onal risk, to
• Prepare 2 tuberculin syringes and withdraw
design and implement adequate nutri onal care
Hep-B and Vit. K injection form the
ampule/vial and other things needed for plan.
cord dress.
• Weigh the baby in pounds then convert to
• Hand washing/Donning of PPE /Open grams.
gloving technique.
• Take temperature rectally.
• WHILE WAITING FOR PULSATION OF THE
U.C TO SLOWED DOWN CLEAN THE - this is also done to check anus patency.
CORD 3X. THIS MIGHT BE DONE ON THE
DELIVERY TABLE WHILE BABY IS IN THE • Disinfect injection site and Inject Hep-B (L)
MOTHER’S ABDOMEN.
0.1 ml and Vit. K (R) 0.5 ml on both thighs
- Clean from the base upward this is to respectively. (VASTUS LATERALIS)
prevent any infection.
- PUT THE CORD CLAMP 1 ½ INCHES - Hep. B. prevent hepa s and for the immunity
FROM THE BASE WHEN PULSATION of the newborn.
STOPS/ SLOWS DOWN AND CUT THE
UMBILICAL CORD. - VIT. K. promote blood cloth and prevent
bleeding.
• Receive baby from the Handle and transfer
3 MINS. INTERVAL FOR EACH VACCINE.
to the cord dress table.
• Apply Credes' prophylaxis
• Final wiping and cleansing of baby's
secretions. - To prevent infection that causes blindness,
since it passes through the birth canal.

• Place baby's wristlet/ID band.

- To iden fy the baby
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 • Check for patency of the anus and
rectal temperature.
• Check the rest of vital signs (HR, RR)
• Put on the rest of the clothing and wrap
the baby snuggly.
- To help them feel safe and secure, e ec ve
way to calm the infants and also warm
them.
• Latch on unless contraindicated.
• AFTERCARE
POSSIBLE Q AND A’s
What are the stages of labor?
- stage 1 - dilation of cervix
- stage 2- delivery of the baby ( starts when
the cervix is fully dilated and ends after the
baby is delivered)
-stage 3 - delivery of placenta ( starts after
the baby is delivered and ends when after
the placenta is delivered)
What phase of labor when the cervix is
dilated from 8-10 cm?
- transition phase
What time is the placenta supposed to be
delivered?
- 5- 30mins after the birth of the newborn
What is dilation?
- enlargement or widening of the cervical
opening & canal once labor has begun
What is e acement?
- shortening & thinning of the cervix during
the rst stage of labor
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What is the normal heart rate of the baby?
Crying ? Sleeping?
-Normal - 120 -160 bpm
- Sleeping- 100 bpm
- Crying- 180 bpm
How many days do lochia rubra last?
-1-3 days
What is the technique when getting the
newborn's respiratory rate?
- newborns are abdominal breathers
Place your hands on their abdomen
How long do you breastfeed the
newbornseach breast of the mother ?
- 15 - 20 mins
What is oxytocin used for?
- stimulates contraction of the uterine
smooth muscle
What is the rst breastmilk of the mother
called?
- Colostrum
Blood loss during postpartum hemorrhage?
- vaginal birth- loss of >500 ml of🩸
- cesarean- > 1,000 ml of 🩸
Blueness of hands and feet during the rst
24 hrs of life of the newborn?(This is normal
btw as long as normal vs )
- acrocyanosis