Unlike what most people think, working in the Labor and Delivery Room isn’t always that nice. Although you get to see babies being born and you get to be a part of someone else’s major life event, there are high-risk pregnancies and at-risk newborns that can challenge your knowledge and skills.
The delivery room is a fast-paced environment and if you’re not familiar with your tools, it can easily cost someone else’s life. So, to help you prepare, check out the most important delivery room tools you need to be familiar with.
This is probably one of the tools that scare a lot of patients and it’s not really surprising why. A speculum is a hinged instrument that is inserted into the patient to help doctors and nurses gauge dilation and effacement. It’s also typically used during annual exams.
It’s made out of metal so be sure to tell your patient to expect a cool sensation. You should also reassure your patient that although they look intimidating, speculums don’t typically cause pain.
There will be a couple of scissors in the delivery room so don’t feel overwhelmed. You just have to know exactly which to pick at what stage in the labor and delivery process of your patient.
Let me give you some hints.
The first pair of scissors you have to keep an eye out for is the episiotomy scissor. It’s used to create a surgical incision to the perineum during the second stage of labor to enlarge the opening for the baby. Episiotomies aren’t always needed. But, if a baby needs to be delivered right away or there’s a risk to the mother, be prepared to grab an episiotomy scissor.
Another tool you need to be aware of is the umbilical scissors. Obviously, this tool is used to cut the baby’s umbilical cord. It’s typically used without the need for clamping since its style holds the cord in place, minimizing cord damage and reducing risks of infection.
If clamping is needed, you need to grab the next tool.
A hemostat looks a lot like a scissor–but it’s not. It’s not sharp, and it doesn’t have blades.
This tool can actually be used for a lot of purposes but it’s most commonly used for clamping the umbilical cord before the doctor cuts it. You may also need a hemostat during suturing and when there’s unexpected bleeding.
Despite their size, sutures are one of the most important delivery room tools. They are used to stitch up and repair the affected tissues either from laceration or episiotomy. They aren’t usually painful since doctors use a local anesthetic to keep the area numb. If you opted for an epidural, a local anesthetic might not be necessary.
If you got an epidural, you may not be able to feel the urge to urinate, and this is where a urinary catheter can help you. It’s typically inserted after the epidural so you won’t feel any discomfort when the tube is slowly pushed into your bladder.
It’s usually removed once the birth is imminent. The doctor can replace it after the birth and removed several hours postpartum or the very next day.
A toco transducer, or simply toco, is a device used to detect and monitor the changes in your patient’s abdomen during a contraction. It records how frequent the contractions happen and how long they last.
Toco transducers are generally placed over the baby’s back or chest cavity. For proper placement, be sure to know how to perform Leopold’s.
If your patient is having a hard time pushing the baby out, a vacuum extractor may be necessary. This is a small suction cup that is placed on top of the baby’s head. When a contraction comes, the doctor will slowly pull the baby out with the device as the mother gently pushes.
Take note that while a vacuum is meant to help with delivery, it can’t really remove the baby from the delivery canal. It’s just a tool to assist in pushing the baby out.
It’s possible for the baby to come out with a cone-shaped head so don’t be alarmed. The baby’s head should go back to its original shape after a couple of weeks.
This is another tool that’s used to help pull out the baby if the mother is already exhausted or if she can’t push anymore. It’s also used when the baby is showing signs of stress and requires to be delivered immediately.
Similar with the vacuum extractor, forceps are used during contractions. The doctor will gently pull on the forceps as the uterus contracts.
Bruises and bumps are expected to appear on the baby’s head. They should heal after a few days.
Normally, your patient’s bag of water should break naturally in the early stages of labor. If that doesn’t happen, the doctor will need to break the membrane using an amniotic hook. This tool looks similar to a knitting or crochet hook.
Before using this tool, the doctor needs to be sure if the patient is already dilated. If she is, the doctor will insert the hook and puncture the amniotic sac. A large gush of fluid should come out after. You can take this opportunity to assess your patient’s amniotic fluid.
If it is already green or brown, it’s a sign that the baby has already passed his first bowel while inside the mother’s womb. If this is the case, make sure to report it to the attending doctor as the meconium can get into the baby’s lungs.
Once this happens, the baby can develop Meconium Aspiration Syndrome. Immediate treatment is necessary to make sure the baby doesn’t experience serious breathing problems. However, if the baby appears to be healthy despite the presence of meconium, treatment may not be needed.
Laparoscopic sponges are typically used to control bleeding during delivery. They are somewhat similar to gauze pads but they can absorb more liquid, making them a much better choice for surgical procedures.