INC 31.

Place the baby to the nursery room

1. Handwashing 32. Documentation
2. Double gloving (open gloving)
3. Dry baby (30 sec)
4. APGAR (Check for breathing)
5. Remove wet drape
6. Remove first layer of gloves
7. Bonnet & ID band
8. Cord clamping and cutting
9. Remove abdominal drape (carry the baby)
10. Position the baby in prone position to the
abdomen of the mother
11. Cover the baby with the drape
12. Observe feeding cues

13. Carry the baby going to the working table

14. Weigh the baby (remove all garment and drape)
used non-dominant hand
15. Place back to the working table
16. Bonnet again
17. APGAR (observed physical assessment)
18. Measure the baby anthropometric
measurement
- head (above eyebrow)
- chest (nipple line)
- abdomen ( below umbilicus)
- mid arm
- body length (cephalo-caudal) measure by
CURVE
19. Position the baby into Supine
20. Placed bonnet (provide drape cover the baby)
21. Disinfect rectal thermometer (tip - bottom)
- Measure rectal temperature
- Disinfect rectal thermometer (bottom - tip)
22. Crede's prophylaxis (inner to outer cantus)
23. Check the ampule (dosage and expiration date)
- Break the ampule (away from you)
- Remove cap the syringe
- Withdraw medication (do not instil air) NOTE:
- Administer Vitamin K All must know:
*term - 0.1 ml 1. Time baby is out
*preterm - 0.05 ml 2. Gender
- Recap syringe 3. REMOVE ALL JEWELRIES
- Locate injection site (vastus lateralis -
upper/outer thigh) INC: make umbilical cord
- Get wet cotton balls a. 2 red yarn
- Disinfect site b. 1 blue yarn
- Get dry cotton State RR (in case moask sila)
- Remove cap of the syringe APGAR Scoring
- Pinch injection site
24. Administer Vitamin K (90 degree angle)
- Aspirate blood first Inject vitamin K
- Remove syringe (apply dry cotton)
25. Place Diaper
26. Place Clothes
27. Set aside baby
28. Place baby blanket
29. Wrap the baby
30. Proceed vital signs
HANDLE/ASSIST 27. Check and observe the placental presentation
1. Hand hygiene and completeness
2. Complete attire
3. Prepare OB Pack -Episiotomy-
*towel (perineum support)
*perineal drape 28. Provide lidocaine with os by assisting nurse
*2 abdominal drapes - Needle w/suture Tissue forceps w/o teeth
*leggings (to grasp muscle)
*2 gowns - Tissue forceps w/teeth (wipe on the surgical
*2 hand towels site)
- Provide surgical scissor w/OS
4. Complete attire (wear bonnet) - Provide Ovum forceps w/ OS
5. OB Pack is prepared 29. Provide normal saline & betadine solution w/
6. Open outer layer of OB pack (Handling Nurse) sterile os
7. Open OB Pack (sterile forcep- inner layer) 30. Check the instrument
Handling nurse 31. Discard sharp object to the sharp container
8. Drop surgical gloves (2 gloves) Handling nurse 32. Wash the instrument properly
9. Open DR Pack (sterile forcep) Assisting Nurse
10. Drying of hands Handling nurse
33. Check the placenta
11. Perform gowning & closed gloving 34. Administer normal saline & betadine solution
*if ever gowning and gloving the doctor to 35. Provide sanitary pad
be done by handling nurse 36. Do after care

- Drape the mother (2 abdominal drape then

leggings) Handling Nurse
- Arrange DR Pack (Assisting nurse)

12. Place needle with thread to the needle holder

(3 teeth)
*right-handed - left facing curve
*left-handed - right facing curve

13. Provide sterile os to the ovum forcep

14. Provide perinial support to the OB
15. Give lidocaine with os by Assisting Nurse
16. Recap syringer
17. Bandage scissor
- proceed to the delivery
- Place the baby to prone position in the
abdomen of the mother
18. If ever there is any secretion - Provide bulb
syringe (assisting nurse)
19. Provide kelly curve by assisting nurse
20. Clamp the cord - 5 cm by handle nurse
21. Provide kelly straight by assisting nurse
22. Clamp the cord - 2 cm using kelly straight by
handle nurse
23. Provide surgical scissor with sterile os by
assisting nurse

-delivery of the placenta-

24. Roll the placental cord with the kelly curve

25. Demonstrate Brandt-Andrew Manuever while
non-dominant hand is placed on the fundus (up,
down, left, right)
26. Provide placental bowl by assisting nurse to the
OB
PREPARATION 2. Demonstrate Brandt-Andrew Manuever using
1. Prepare OB Pack your dominant hand (up, down, left, right) while
*towel (perineum support) the non-dominant hand is placed on the fundus.
*perineal drape 3. Check and observe the placental presentation
*2 abdominal drapes and its completeness
*2 leggings a. Schultz – shiny and complete (fetal side)
*2 gowns b. Duncan – dirty and incomplete (mother
*2 hand towels side)

Episiorraphy
Handling Nurse 1. Instill lidocaine with OS (5cc imo ihatag) in the
Preparation perineum
1. Complete attire (wear bonnet) 2. Do suture
2. OB Pack is prepared 3. Use tissue forceps w/o teeth (to grasp muscle)
3. Open OB Pack 4. Use tissue forceps w/teeth (to grasp the skin)
- Outer portion = bare hands 5. Cut the thread using surgical scissors
- Inner portion = Sterile forceps)
4. Drop 2 pairs of surgical gloves to the sterile field *If ever there is a retained placental fragment
(+1 pair if OB is included) 6. Check the uterus using an Ovum Forceps w/
sterile gauze
Implementation 7. Administer normal saline & betadine solution
1. Hand hygiene (Medical and Surgical 8. Perineal Care
Handwashing) 9. Give Ice Packs
2. Drying of hands using the hand towel 10. Provide sanitary pad and diaper
3. Perform gowning & closed gloving 11. Change mother’s gown
*If ever the doctor is included, perform 12. Take Vital Signs
gowning and closed gloving to the OB 13. Do aftercare
4. Drape the mother (2 abdominal drapes then
leggings)
5. Provide perineal support to the OB Assisting Nurse
Preparation
Episiotomy 1. Complete attire (wear bonnet)
6. Instill lidocaine with OS (5cc imo ihatag) 2. Gather the lacking equipment (iwrap og
7. Cut the perineum using a bandage scissor bondpaper kay iopen na sya nga morag gloves
nga idrop para sa sterile field)
After Delivery - 10 Sterile OS
1. Place the baby in a prone position in the - 10 cc syringe
abdomen of the mother - Bulb syringe
*If ever there is any secretion, suction the - Suture
mouth and nose using bulb syringe - Cord clamp
2. Clamp the cord 5 cm using Kelly CURVE
(position the tip of the forceps facing towards 3. Drop the equipment in the sterile field
you)
3. Clamp the cord 2 cm using Kelly STRAIGHT (tip
must face the baby)
4. Cut the cord using surgical scissors with OS

Placental Delivery
Take Note first:
 3-5 mins to check if there is placental
separation (Naa ra sad ni sa RLE Manual)
A. Calkin’s sign (globular shape of fundus)
B. Lengthening of cord
C. Gush of Blood
D. Uterus rise in abdomen
Implementation
1. Roll the placenta cord with the use of kelly 1. Hand hygiene (Medical and Surgical
curve Handwashing)
2. Drying of hands using the hand towel
 3. Perform gowning & closed gloving NOTE:
4. Arrange DR Pack
5. Place the needle with thread in the needle Handle:
holder (3rd teeth) 1. ang pagcut para sa epiosotomy is median-
*right-handed - left facing curve lateral
*left-handed – right facing curve 2. check kung unsa ang placenta
6. Wrap sterile OS in the Ovum forcep
Assist:
Episiotomy 1. Inig aftercare kay check for the instruments
7. Give lidocaine with OS to the OB and OS
8. Provide Bandage scissors to the OB 2. Wash the equipments and then clean and
9. Recap syringe autoclave
3. Sharp objects ibutang sa sharp container
After Delivery
*If ever there are any secretions in the infant
1. Provide bulb syringe to the OB
2. Provide kelly curve
3. Provide kelly straight
4. Provide surgical scissors with sterile OS

Placental Delivery
1. Provide a placental bowl

Episiorraphy
1. Provide lidocaine with OS
2. Provide Needle w/suture
3. Provide Tissue forceps w/o teeth (to grasp
muscle)
4. Provide Tissue forceps w/teeth (to grasps skin)
5. Provide surgical scissors w/OS
6. Provide Ovum forceps w/ OS
7. Provide normal saline & betadine solution w/
sterile OS
8. Check the instruments
9. Discard the sharp object to the sharp container
10. Wash the instrument properly

Suture