INTRAPARTAL CARE

1. Wash hands before entering the delivery room

2. Receive patient from Labor Room, OB-ER, or DDR vial stretcher, wheelchair, or ambulatory
3. Introduce yourself
4. Ask patient “ikapilang pagbuntis?” “ikapila na nimong panganak?” “nibuto na ba imong
panubigan?”
5. Usher patient to delivery table
6. Assist to lithotomy position
7. Ask the patient for cellophane with contents: underpad, adult diaper, baby’s bonnet, upper
clothing, and 2 extra linen (1 thin and 1 thick)
8. Label the cellophane
9. Place the cellophane on the head part of the mother or hang
10. Put the underpad under the mother
11. Get a pail with cellophane ibutang tungod sa mother
12. Monitors progress of labor (frequency-how often mostly every 2mins, duration-how long the
contractions last mostly 90seconds, intensity-degree of contraction measured in %, and interval-
gap and the resting phase) and observes for the timely rupture of membrane
13. Get DR pack and place on the table
14. Open the pack using picking forcep
15. Arrange the hapin sa DR pack still using the picking forcep
16. Get 2 scissors soaked with cydex from the soaking pan and rinse with saline solution in the
rinsing pan para di mapaso ang panit sa mother kay isog nga tambal. 2 scissors for primi because
1 for episiotomy and 1 for cutting the cord and knot of suture
17. Place scissors on sterile table
18. Get necessary accessories: OS, 10cc syringe, cord clamp, suture and place them on the table
observing sterility.
*Linens (accrdng to use): leggings, abdominal towel, supporting towel, drying towel, buttocks
towel
19. Wear gloves (double gloving)
20. Arrange instruments and accessories on the table (1st scissor, Kelly curve, Kelly straight, 2nd
scissor, needle holder, tissue forcep, syringe, cord clamp, suture, OS)
21. Fill 10cc syringe with lidocaine
22. Place suture on needle holder. Turn needle holder upside-down
23. Ask immediate for assistance in placing the leggings. Observe sterility. Locate the foot part left
and right before abdominal part. This is to widen the sterile area.
24. Offer abdominal towel to immediate
25. “Flushing please” done before episiotomy
26. Offer scissors to doctor if primi patients
27. Get supporting towel and support the episiotomy site to prevent lacerations (2 types of
episiotomy: median and mediolateral)
28. Drop supporting towel if baby’s feet are out
29. Offer drying towel to immediate
30. Feel cord pulsations for 1 to 3 mins
31. “Pulsations stopped”
32. Offer cord clamp to immediate
33. Clamp 5cm milked area from the base with Kelly forcep
34. Offer 2nd scissor to immediate for cord-cutting. Place back scissors to table.
35. Cord traction. Rolling of the cord. (signs of placental separation: gushing of blood, lengthening of
the cord, changes in shape of the uterus)
36. “Placenta out. BP please.”
37. Place placenta in bassinette. Put in the sink.
38. Place buttocks towel
39. Remove first pair of gloves
40. Offer lidocaine to doctor
41. Offer needle holder with suture
42. Use 2nd scissor to cut suture just above the knot
43. Use of OS if needed
44. Flushing
45. Apply betadine
46. Remove buttocks towel by rolling then i-hapin sa floor
47. Remove drying towel by rolling then ipatong sa hapin
48. Remove leggings by rolling then ipatong sa hapin
49. Remove underpad by rolling and put on diapers
50. Dispose underpad in the infectious
51. Tie the soiled linens
52. Dispose syringe and sharps (needle and suture)
53. Place instruments to the sink and wash. Soak 2 scissors in cydex
54. Documentation
55. Transport patient to ward
IMMEDIATE CARE

1. Perform proper handwashing

2. Prepare baby’s clothing, bonet, 2 linens, diaper
3. Maintain adequacy of supplies
4. Maintain warmth and check temperature of environment
5. Observe precautionary measures related to use of electrical equipment such as gooseneck lamp
6. Prepare 2 pair of gloves, erythromycin, vitamin K, hep B shots vaccine
7. Wash hands
8. Put on gloves (double gloving)
9. Call out time of birth
10. Thorough drying of the baby for 30 seconds
11. Check breathing while drying
12. Remove abdominal towel
13. Skin to skin contact
14. Put on bonnet
15. Remove first pair of gloves
16. Clamp cord 2cm to 1 inch away from the base of umbilicus
17. Milk the cord 5cm
18. Clamp 5cm using Kelly forcep
19. Cut the cord
20. Put on drying towel over the baby
21. Take anthropometric measurements of baby (HC-34 to 35, CC-33 to 34, AC 30-33, length-47 to
50, weight-2.7 to 3.4 kg)
22. Weigh baby in scale. Remove bonnet and put back.
23. Return baby to abdomen
24. Put on upper clothing
25. Put anklet with mother’s name, date and time of delivery, gender, name of doctor
26. Check vital signs: temp (anus- to check for imperforate anus 37.2C), HR (120-160), RR (30-60)
27. Place thin linen on diaper
28. Put on diaper
29. Administer medications: erythromycin (antibacterial and prevent eye infection), vitamin K (0.1-
using tuberculin or 1cc syringe-left leg vastus lateralis divide into 4 and inject in upper outer-
promote coagulation and prevent blood loss), hepatitis B (0.5-tuberculin or 1cc syringe-right leg
vastus lateralis into 4 and inject in upper outer)
30. Prone position inside the daster
31. aftercare