Im injection
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This document provides instructions for intramuscular injections in newborns. It states that the anterolateral thigh is the preferred site for IM injections in newborns, not the gluteal region, due to risks of nerve injury and poor drug absorption in the underdeveloped gluteal muscles. The procedure involves preparing the syringe with the correct needle size, cleaning the injection site with alcohol, grasping the thigh muscle between the thumb and finger, injecting the drug at a 90 degree angle into the vastus lateralis muscle, and properly disposing of medical waste.
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Alternative terms: Postcoital contraception- still commonly used and 'morning after' contraception
Emergency contraception is not true contraception but rightly called interception. Interceptive - agents that do not interfere with fertilization but act on blastocyst before or soon after missing periods.
Emergency contraception is a backup plan. It cannot be used as an ongoing method of contraception because:
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1. For aged couples who meet very infrequently.
2. Following single act of sexual exposure in young girls
3. When pregnancy is apprehended owing to rupture of condom, premature ejaculation in couples practising coitus interruptus etc.
4. In case of rape.
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From unnecessary operative interferences for fear of pregnancy
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Helps to reduce unsafe abortion
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Cont.
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Cont..
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4. In case of rape.
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Saves the couple from unwanted pregnancies
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From the agony of waiting for the next menstrual cycle.
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Failure rate- 0-2%
Ovral tablets (each containing 50 µg ethinyl estradiol and 250 µg levonorgestrel) are most commonly used to provide these doses.
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Failure rate- 0-1%
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1. Nausea- in 50% using Yuzpe regimen & 20% for Levonorgestrel.
2. Vomiting - in 20% Yuzpe regimen & 5% using LNG-only pills.
If vomiting occurs within 2 hours of taking the pills - the dose should be repeated. In cases of severe vomiting - administer pills vaginally.
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This document discusses breast complications that can occur during the postpartum period known as the puerperium. The common complications include breast engorgement, cracked or retracted nipples, mastitis, breast abscesses, and lactation failure. Symptoms, causes, treatment and prevention are described for each complication. Nursing assessments, diagnoses, interventions, and evaluations are also outlined to manage breast issues and support breastfeeding during recovery after childbirth.
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breastfeeding should be given exclusively in our country as our country has so many incidence of malnutrition. BFHI is doing their work to promote successful breastfeeding.
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no prelacteal food should be given
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The document discusses lactation and breastfeeding. It defines lactation as the secretion of milk by the breasts, which is brought about by hormones like progesterone, estrogen, prolactin, and oxytocin. The purposes of lactation are to provide nutrition and immune protection to newborns and induce postpartum infertility. The document then covers physiology of lactation, initiation of breastfeeding, hormones involved, problems, human milk banking, and the Baby Friendly Hospital Initiative.
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The document discusses NABH (National Accreditation Board for Hospitals and Healthcare Providers), which sets standards for quality healthcare in India. It establishes that quality refers to how good or satisfying a service is, as well as meeting certain standards. Quality of care means providing treatment that benefits patients without harming them using tested methods. Accreditation involves an external review to ensure healthcare organizations comply with NABH standards. NABH has 10 chapters and over 100 standards covering both patient-centered and organization-centered areas like access to care, patient rights, infection control, and management responsibilities. Benefits of NABH accreditation include improved health outcomes, client and staff satisfaction, and a better reputation for healthcare institutions
Hospital introduction
This document provides an overview of Chaitanya Hospital, a leading institute of maternal and child healthcare in the region. It summarizes the hospital's mission to provide high quality maternal and child healthcare services with honesty and integrity. The document outlines the hospital's history since 1993, facilities and services offered, which include neonatal ICU, pediatric ICU, obstetrics, gynecology and fertility services. It also provides details on infrastructure, staffing, quality certifications and awards received, and future plans to expand to a 100 bedded superspeciality hospital.
Infection prevention and control
Standard precautions are a set of practices used to prevent transmission of infectious diseases. They include hand hygiene, use of personal protective equipment, respiratory hygiene, safe injection practices, proper handling and disposal of linens and medical waste, cleaning and disinfection, and patient placement. Standard precautions should be applied universally for all patient care regardless of diagnosis or infectious status.
Biomedical Waste
The document categorizes and describes different types of bio-medical waste according to the Bio-Medical Waste Management Rules of 2016. It outlines the yellow, red, white, and blue categories of waste. The yellow category includes human tissues, soiled waste, expired medicines, chemicals, and contaminated linens. The red category includes recyclable contaminated waste. The white category includes sharps including needles and blades. The blue category includes glassware and broken implants. The rules also specify that bio-medical waste containers must be labeled as "handle with care" and include non-washable labels.
Weight Recording
Recording weight is important for newborns and preterm babies to monitor nutrition, hydration, and growth. Weights should be recorded at birth and regularly thereafter based on guidelines. The procedure describes accurately weighing babies using a digital scale. Key steps include preparing the scale with a clean towel, removing any tubes or equipment, recording weight while still, and using consistent methods over time and between babies. Daily weights help care teams identify issues and ensure proper growth.
Radiant Warmers and Incubators
This document discusses radiant warmers and incubators used in neonatal care. Radiant warmers use overhead heating elements to provide infrared radiation and maintain a warm microenvironment for the infant. Incubators provide closed environments that reduce heat and moisture losses through conduction, radiation, and evaporation. Both systems aim to control the infant's temperature, but radiant warmers allow for more access while incubators better regulate the environment and reduce infection risks. Precautions must be taken with both to avoid overheating or hypothermia in fragile neonatal patients.
OG Insertion
This document provides instructions for inserting an orogastric tube and orogastric tube feeding in infants. It describes measuring and inserting the tube, confirming proper placement, and giving tube feeds. Key steps include measuring the tube length needed for insertion, gently pushing the tube into the stomach until the measurement mark is reached, checking placement by aspirating or injecting air and listening with a stethoscope, and slowly feeding the infant by gravity while closely monitoring for any signs of distress. Care must be taken to insert the tube gently and watch for apnea, bradycardia or other issues during the process.
KMC
This document discusses Kangaroo Mother Care (KMC), an approach where preterm or low birth weight infants are held skin-to-skin against the mother's chest. KMC aims to provide warmth, safety, nutrition and support to immature newborns, similar to how a kangaroo carries its joey. The document outlines the origins of KMC, components like positioning and breastfeeding, benefits like improved health outcomes and bonding, and calls for KMC to be integrated globally based on its effectiveness.
IV Canulation
This document provides guidance on intravenous cannulation and monitoring intravenous lines in newborns. It outlines the purpose, equipment, procedure, and monitoring required for IV cannulation and maintenance. Key steps include identifying a suitable vein, cleaning the skin, inserting and securing the cannula, attaching IV lines, documenting access and medications, and monitoring the site hourly for complications like infiltration, phlebitis, or clotting. Close monitoring of IV lines is emphasized to prevent complications and promote early detection and treatment if issues arise.
Hypothermia
This document discusses hypothermia and thermoregulation in newborns. It begins by explaining the four main mechanisms of heat loss in newborns: conduction, convection, evaporation, and radiation. It then discusses factors that determine heat loss through each mechanism. The document outlines signs and consequences of hypothermia as well as why preterm infants are more susceptible. It provides recommendations for preventing hypothermia including maintaining warmth in the delivery room and encouraging skin-to-skin contact and breastfeeding. Guidelines for warming hypothermic infants and managing more severe cases are also presented. The document concludes by briefly discussing hyperthermia and its management.
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Im injection
- 2. PURPOSE • For administration of vitamin K, vaccines. • IM injections are always given in the anterolateral aspects of thigh. • In newborns DO NOT USE GLUTEAL REGION for IM injections • In newborns because unlike older children the risk of inadvertent injury to sciatic nerve resulting in paralysis of the limb is high in newborn babies. • Morever gluteal muscles are under developed leading to poor absorption of medications in them.
- 3. EQUIPMENT 1. Disposable syringe with needle size 23G/26 G 2. Cotton swabs 3. Alcohol/spirit 4. Sterile gloves
- 4. PROCEDURE 1. While observing the three checks -check the drug while taking out from shelf , before loading and before replacement. Load the required dose in a syringe attached with needle. 2. Attach a fresh needle use 1/2 ml syringe with 26 G needle for vitamin K. 3. Ask the mother to breastfeed or use oral sucrose to decrease pain. 4. Restrain the baby. 5. Expose the thigh and identify injection site (lateral side of the thigh) and extend the leg to make muscle prominent. 6. Cleanse the site with isopropyl alcohol; let it dry.
- 5. 7. Grasp the muscle between thumb and finger of your hand and introduce the needle of the loaded syringe at right angles into the middle of vastus lateralis muscle 8. Aspirate the syringe to rule out that the needle is not in a blood vessel (if blood is aspirated take out the needle and prick again at another site). 9. Inject the required amount of medication. 10.Withdraw the needle. 11. Press with dry cotton, don't rub. PROCEDURE
- 6. 12. Dispose needle and syringe as per biomedical waste disposal policy 13. Document the medication administered Intramuscular PROCEDURE
- 7. THANK YOU