INSTRUMENTS USED And their FUNCTIONS

Submitted to: Ma. Theresa Ganongan, R.N Clinical Instructor- ER

Submitted by: Angelyn C. Ebes Student

August 10, 2011

INSTRUMENTS USED in NSD and its function(s):

MAYO SCISSORS - Used to cut the umbilical cord. - Used to cut the perineum during episiotomy. KELLY CLAMP (CURVED) - Used to clamp the cord towards the baby. KELLY CLAMP (STRAIGHT) - Used to clamp the cord towards the placenta. RUBBER SUCTION BULB - Used to suction oral and nasal secretions of the baby. STERILE GAUZE - Used for dressing, cleaning and prepping procedures. STERILE TOWEL - Used to provide a sterile working area. GLOVES - Used to protect the hand from possible contaminant and as barrier between sterile and unsterile area. MAYO TABLE - It carries the instrument for the operation. - It is used to simplify the work in the operating theatre. MAYO TRAY - It is where all instruments are placed. METZENBAUM - Used to cut suture during episiorraphy. NEDDLE HOLDER - Used to hold needle. TISSUE FORCEP - Used for grasping, manipulating, or extracting, and holding objects. THUMB FORCEP - Used for grasping soft tissue. - Used to grasp delicate tissue or wound dressing. - Also called as dressing forceps. SUTURE - Used to hold body tissues together after an injury or surgery.

SYRINGE - Used to accurately measure doses of liquid. CATHETER - Used for drainage, administration of fluids or gases, or access by surgical instruments. SUCTIONING MACHINE and SUCTION TUBES - For aspirating fluids and vomit from the mouth and airways, and from operation sites by sucking the material through a catheter into a bottle. - Suction tubes are used for the removal of blood, tissue, and fluids from the surgical site to allow surgeons a clear view of the anatomical structures during the operative procedure.

OTHER INSTRUMENTS:
CORD CLAMP OXYGEN MASK MIXTER PLACENTA FORCEP KIDNEY BASIN

Normal Spontaneous Delivery (Vaginal Birth, Spontaneous Vaginal Delivery (SVD), Normal Vaginal Delivery), is the term used to describe any delivery of the baby through the vagina. Labor and delivery is the culmination of pregnancy, but the beginning of parenting.

Preparation for delivery

- Women are admitted to the labor suite for frequent observation until delivery. - If labor is active, they should receive little or nothing by mouth to prevent possible vomiting and aspiration during delivery or in case emergency delivery with general anesthesia is necessary. - Enemas and shaving or clipping of vulvar hair are no longer indicated. - An IV infusion of Ringer's lactate may be started, preferably using a large-bore indwelling catheter inserted into a vein in the hand or forearm. During a normal labor of 6 to 10 h, women should be given 500 to 1000 mL of this solution. The infusion prevents dehydration during labor and subsequent hemoconcentration and maintains an adequate circulating blood volume. The catheter also provides immediate access for drugs or blood if needed. - Fluid preloading is valuable if epidural or spinal anesthesia is planned.

Stages of Labor
The stages of normal human birth FIRST STAGE: STAGE OF CERVICAL DILATATION The first stage of labor starts classically begins with the true labor contractions and ends with complete effacement and dilatation of the cervix. Cervical effacement occurs during the closing weeks of pregnancy and is usually complete or near complete, by the end of latent phase. Cervical effacement is the incorporation of the cervix to form the lower segment of the cervix. It will usually be accomplished

fully prior to the onset of labor. The degree of cervical effacement may be felt during a vaginal examination. Latent phase (Early) - Latent phase ends with the onset of active first stage; when the cervix is about three cm. dilated. - Contraction is every 5- 10 minutes, 20- 40 sec., mild intensity and establishes a regular pattern.

Active phase - Dilates from 7- 7 cm. - Contraction is every 2-5 minutes, 30- 50 sec., mild- moderate intensity. - The average dilatation is 1.2 cm/hr in primipara and 1.5 cm/ hr in multipara. Transitional phase - Dilates in 8-10 cm - Contraction is 2-3 minutes, 50-60 sec., moderate strong SECOND STAGE: STAGE OF EXPULSION This stage begins when the cervix is fully dilated, and ends when the baby is finally delivered. At the beginning of the normal second stage, the head is fully engaged in the pelvis; the widest diameter of the head has successfully passed through the pelvic brim. Delivery of the fetal head signals the successful completion of the fourth mechanism of labor (delivery by extension), and is followed by the fifth and sixth mechanisms (restitution and external rotation). The second stage of labor will vary to some extent, depending on how successfully the preceding tasks have been accomplished. The medical condition of the child is assessed with the Apgar score, based on five parameters. A good start refers to higher scores, while a child doing poorly will have low scores that do not improve rapidly over time. THIRD STAGE: STAGE OF PLACENTAL DELIVERY In this stage, the uterus expels the placenta (afterbirth). Maternal blood loss is limited by the compression of the spiral arteries of the uterus as they pass though the lattice-like uterine muscles of the upper segment. Normal blood loss is less than 600 mL. The placenta is usually delivered within 15 minutes of the baby being born.

Complications

Complications occasionally arise during childbirth; generally require management by an obstetrician.

these

- Non-progression of labor (longterm contractions without adequate cervical dilation) is generally treated with cervical prostaglandin gel or intravenous synthetic oxytocin preparations. If this is ineffective, Caesarean section may be necessary. - Fetal distress is the development of signs of distress by the child. These may include rising or decreasing heartbeat (monitored on cardiotocography/CTG), shedding of meconium in the amniotic fluid, and other signs. - Non-progression of expulsion (the head or presenting parts are not delivered despite adequate contractions): this can require interventions such as vacuum extraction, forceps extraction and Caesarean section. In the past, a great many women died during or shortly after childbirth but modern medical techniques available in industrialized countries have greatly reduced this total.

Contraindications
Several factors can influence the ability vaginal delivery to occur. These include: - complete placenta previa, - herpes virus with active lesions, - previous classic uterine incision - untreated HIV infection. of a spontaneous