Management of Shoulder Dystocia

The HELPERR Mnemonic

Basic and immediate intervention in management of shoulder dystocia.

H - Call for help.

This refers to activating the pre-arranged protocol or requesting the appropriate personnel to respond with necessary equipment to the labor and delivery unit.

E - Evaluate for episiotomy.

Episiotomy should be considered throughout the management of shoulder dystocia but is necessary only to make more room if rotation maneuvers are required. Shoulder dystocia is a bony impaction, so episiotomy alone will not release the shoulder. Because most cases of shoulder dystocia can be relieved with the Mc Roberts maneuver and supra pubic pressure, many women can be spared a surgical incision.

Electrocardiography (ECG)

Introduction

• The ECG is a basic investigation that is widely used in medicine
• You are guided through a module based on your objectives.
• This package teaches you the important fundamentals of recording a 12-lead ECG and labeling the ECG.
• Numerous patient cases are provided for evaluation while your understanding of material will be tested at the end of the module

Normal activation of the heart

• The resting potential is maintained by ionic gradients across the cells with a higher sodium concentration outside and higher potassium concentration inside
• Following a stimulus, a rapid inward movement of sodium occurs causing a loss of the negative internal potential. This is called as depolarization.
• This is followed by repolarization, a slower process than depolarization where the potassium moves out of the cell

Disinfection and sterilization

Importance of sterilization,
In health care setting it is important;

• To render articles and environment safe from the risk of transmitting infections.
•  Pathogens on hands & environment are removed or destroyed by ,

–        high standard of cleanliness

–        drying, washing, good ventilation and sun light.

 

o   Wards should be well ventilated and sunny.

● High risk procedures

o       Require absolute sterility

–        Surgery

–        preparation

•         of culture media

•         Iv fluids and other injectable drugs

–        Types of research work

Sharp tools

●   Sharp tools in use in hospital setting:

• Syringes and needles
• Scalpel blades
• Razors
• Infusion sets
• Lancets
• Broken glass

● Why proper handling and disposal of sharps is important?

• Improper handling and disposal of sharps leads to acquisition of infections by Healthcare Workers during their work ( occupational health hazards).
• This leads to transmission of blood borne infections namely HBV, HCV AND HIV  infections among patients as well as Healthcare workers.
• Proper handling and disposal of sharps leads to the minimization of the risk of getting infected by above blood borne infections. 

 

Hand hygiene

• On average, 8.7% of hospital patients suffer nosocomial infections.
• Hospital infections are a leading cause of death in some parts of the world.
• Most patient deaths and suffering attributable to health care-associated infections can be prevented.
• The costs of health care-associated infections vary by country and institution. 
• The single most important measure to prevent and control health care -associated.

Benefits of hand washing are,

• Reduces nosocomial infections
• Preventing cross transmission of multi-resistant organisms
• Preventing and control epidemics
• Cost saving
• Reduces morbidity and mortality