Episiotomy Check List

Download as docx, pdf, or txt
Download as docx, pdf, or txt
You are on page 1of 3

Episiotomy check list

Rate the performance of each step or task observed using the following rating scale:
1. Needs Improvement: Step or task not performed correctly or out of sequence (if necessary) or
is omitted
2. Competently Performed: Step or task performed correctly in proper sequence (if necessary)
but participant/student does not progress from step to step efficiently
3. Proficiently Performed: Step or task efficiently and precisely performed in the proper
sequence (if necessary
STEP/TASK
CASES
GETTING READY
1. Prepare the necessary equipment
2.Tell the woman what is going to be done and encourage her to ask questions
3. .Listen to what the woman has to say
4. Make sure that the woman has no allergies to lidocaine or related drugs
5. Provide emotional support and reassurance, as feasible
ADMINISTERING LOCAL ANESTHETIC
1. Cleanse perineum with non alcohol antiseptic solution.
2. Draw 10 ml of 0.5% or 1% lignocaine / lidocaine into asyringe:
 (To prepare 0.5% from 2% lignocaine –draw 2.5ml Lignocaine and
draw 7.5ml of water for injection.
 To prepare 1% from 2% lignocaine: 5ml lidocaine and 5ml sterile
Water)

3. Place two fingers into vagina along proposed incision line (medio-
lateral direction).
4. Insert needle beneath skin for 4–5 cm following same line.
5. Draw back the plunger of syringe to make sure that needle is not in a
blood vessel:
 If blood is returned in syringe, remove needle, recheck position
carefully, and try again;
 If no blood is withdrawn, continue as follows.

6. Inject lidocaine into vaginal mucosa, beneath skin of perineum and


deeply into perineal muscle instill slowly while withdrawing the needle, do
the same in all three directions
7. Wait 2 minutes and then pinch incision site with forceps
8. If the woman feels the pinch, wait 2 more minutes and then retest.
MAKING THE EPISIOTOMY
1. Wait to perform episiotomy until: Perineum is thinned out 3-4 cm of the
baby's head is visible during a contraction
2. Place two fingers between the baby's head and the perineum.
3. Insert open blade of scissors between perineum and two fingers and cut
mediolaterally the perineum and posterior vagina
4. If birth of head does not follow immediately, apply pressure to episiotomy
site between contractions, using a piece of gauze, to minimize bleeding.
5. Control birth of head and shoulders to avoid extension of the episiotomy
REPAIRING EPISIOTOMY
1. Ask the woman to position her buttocks toward lower end of bed or table
2. Check if the sensitivity has returned to the incision area, If Yes, repeat giving
lignocaine 5ml of 0.5%
2. Ask an assistant to direct a strong light onto the woman's perineum.
3. Check if the episiotomy has extended through anal sphincter or rectal
rd th
mucosa and if so manage as 3 or 4 degree tears respectively.
4. Gently clean area around episiotomy with antiseptic solution.
5. Ensure a sterile field by putting a sterile drape under the woman’s buttocks
6. Using 2/0 suture, insert suture needle just above (1 cm) the apex of the
vaginal cut
7. Use a continuous suture from apex downward to level of vaginal
opening.
8. At opening of vagina, bring together cut edges.
9. Bring needle under vaginal opening and out through incision and tie.
10. Use interrupted or continuous sutures to repair perineal muscle, working
from top of perineal incision downward.
11. Use interrupted or continuous subcuticular sutures to bring skin edges
together.
12. Wash perineal area with antiseptic, pat dry, and place a sterile sanitary
pad over the vulva and perineum.
POST-PROCEDURAL TASK
1. Dispose of waste materials (e.g., blood-contaminated swabs) in a leak
proof container or plastic bag.
2. Decontaminate instruments by placing in a plastic container filled with
0.5% chlorine solution for 10minutes.
3. Dispose of needle and syringe in a puncture proof container
4. Remove gloves and immense in 0.5% chlorine solution then turn them
inside out and place in leak proof container or plastic bag.
5. Wash hands thoroughly with soap and water and dry with clean, dry
cloth or air dry.
6. Explain to the woman how to keep the area clean and dry and to return
for post partum care.
7. Offer the woman analgesic/anti-inflammatory for48hrs:
 Diclofenac 50 mg b.i.d if no contraindications
8. Record the procedure on woman’s record.

You might also like

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy