Essential Preparation for Safe Delivery Procedures
Learn about the necessary items and equipment required for safe delivery procedures, including personal protective equipment, trays, and kits to be kept in the labor room. Understand the importance of pre-filled syringes and the contents of delivery, episiotomy, baby, and medicine trays for ensuring a smooth delivery process.
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Learning Objectives At the end of the sessions, learners will be able to: List the items of personal protective equipment (PPE) to be worn by the provider to conduct normal delivery List the seven trays as per GoI s recommendation (depending upon level of facility) and three additional trays/kits, and their contents to be kept ready in LR Describe the importance of pre-filled syringe with 10 IU Oxytocin kept ready before delivery by the side of delivery tray 2
Trays/Kits to be Kept in Labour Room 7 Trays (as per GoI s MNH Toolkit): Delivery tray Episiotomy tray Medicine tray Emergency drug tray Baby tray MVA tray PPIUCD tray Additional trays/kits: Examination Tray PPH Management Kit Severe PE/E Management Kit 3
Delivery Tray Sterile Gloves Speculum, Urinary catheter -1each Bowl for antiseptic lotion- 1 Sponge holding forceps-1 Gauze pieces, Cotton swabs Sterile perineal pads-2 Artery forceps-2 Scissor- 1 Kidney tray- 1 Cord clamp-1 4
Episiotomy Tray Inj. Xylocaine 2% 10 ml disposable syringe with needle Episiotomy scissor, Artery forceps Allis forceps, Sponge holding forceps, Toothed forceps Thumb forceps, Kidney tray, Needle holder Needle (round body and cutting) Chromic catgut no. 0, Gauze pieces, Cotton swabs, Antiseptic lotion, Gloves 5
Baby Tray Two pre-warmed towels/sheets for wrapping the baby (Baby should be received in a pre-warmed towel. Do not use metallic tray for receiving baby.) Mucus extractor, cotton swabs Nasogastric tube, Gloves Bag and mask, Sterilized thread/cord clamp, Needle (26 gauze) and syringe (1 ml) Inj. Vitamin K, needle and syringe 6
Medicine Tray* Inj. Oxytocin 10 IU (to be kept in fridge), Inj. Gentamicin, Inj. Vit K, Inj. Betamethason, Inj. Hydralazine Cap Ampicillin 500 mg, Tab. Metronidazole 400 mg, Tab Paracetamol, Tab Ibuprofen, Tab B complex, Tab. Misoprostol 200 micrograms, Tab. Nifedipine, Tab. Methyldopa IV fluids - Ringer lactate, Normal Saline, Magnifying glass (*Nevirapin and other HIV drugs only for ICTC and ART Centres) 7
Emergency Drug Tray** Inj. Oxytocin (to be kept in fridge), Inj. Magnesium sulphate 50%, Inj. Calcium gluconate-10%, Inj. Dexamethasone, Inj. Ampicillin, Inj. Gentamicin, Inj. Metronidazole, Inj. Lignocaine-2%, Inj. Adrenaline, Inj. Hydrocortisone Succinate Inj. Diazepam, Inj. Pheneraminemaleate, Inj. Carboprost (to be kept in fridge), Inj. Pentazocin chloride, Inj. Promethazine, Inj. Betamethasone (to be kept in fridge), Inj. Hydralazine IV fluids- Ringer lactate, normal saline, IV sets with 16-gauge needle at least two, IV Cannula, Vials for blood collection Syringes and needles, Tab.Nifedipine, Tab.Methyldopa, Suction catheter, Mouth gag. Ceftraixone (3rd generation cephalosporin for L3 facility) (**only for L2, L3 facilities) 8
MVA/EVA and PPIUCD Tray MVA/EVA Tray: PPIUCD Tray Gloves, speculum, anterior vaginal wall retractor, posterior vaginal wall retractor, sponge holding forceps Cu IUCD 380A/ Cu IUCD 375 in a sterile package PPIUCD Insertion Forceps, sims speculum, sponge holding forceps, bowl with swabs MVA syringe and cannulas, MTP cannulas Small bowl of antiseptic lotion, sanitary pads, pads /cotton swabs, disposable syringe and needle, sterilized gauze/pads, urinary catheter Only for L3 facilities with PPIUCD trained provider) Misoprostol tablet 9
Examination Tray SS tray Knee hammer Bowl with cotton swabs MCP cards Sterile gloves Blood and urine collection vials, alcohol swabs Antiseptic solution bottle RDKs (to be kept in refrigerator) Measuring tape Stethoscope/ Foetoscope Uristix bottle BP apparatus Thermometer 10
PPH Management Kit Wide bore cannula (number 16/18)- at least 2 IV set, IV fluids (NS, RL), Syringes (10 mL, 5 mL, 2 mL), Blood and urine collection vials Inj. Oxytocin (to be kept in refrigerator), Tab. Misoprostol, Inj. Methylergometrine, Inj. Carboprost (to be kept in refrigerator) Bowl with cotton swabs, Alcohol/spirit swabs, Antiseptic solution bottle, Adhesive tape, Suture material, Dry cotton swabs Self-retaining catheter, Urobag, Syringe & distilled water for inflation Long elbow-length sterile gloves, Sterile gloves For Condom Tamponade: SS tray with lid, Sims speculum, SS bowl with swabs, Sponge holders, Suture material, Scissors, Foley s catheter (16 no.), Condoms, IV set, 500 mL NS, PPE *Ensure availability of functional oxygen source with attachments, functional suction machine and functional BP apparatus and stethoscope. 11
Severe PE/E Management Kit Mouth gag, Suction catheter IV cannula, IV set, IV fluids (RL), Syringes (20 mL, 10 mL, 5 mL) Antihypertensive drugs (Labetalol- Tab & Inj., Tab. Nifedipine) Inj. Magnesium sulfate- at least 20 ampoules (1 amp = 1 gm) 2% xylocaine, Alcohol swabs, Adhesive tape, Antiseptic solution bottle, Blood and urine collection vials Self-retaining catheter, Urobag, Syringe & distilled water for inflation, dry cotton swabs Sterile gloves, knee hammer, Inj. Calcium Gluconate *Ensure availability of functional oxygen source with attachments, functional suction machine and functional BP apparatus and stethoscope. 12
Pre-filled Oxytocin Syringe Pre filled 10 IU oxytocin syringe (by the side of delivery tray) helps in Ensuring that the mother receives Inj Oxytocin 10 I.U. immediately after delivery Reducing confusion and need for health worker to step away from mother to pick and fill Oxytocin syringe 13
Key Messages For safe delivery PPE should be worn by providers to prevent infection All seven trays must be kept ready in LR as recommended in GoI s MNH tool kit. Always keep pre-filled syringe with 10 IU oxytocin by the side of delivery tray. This helps providers to ensure that mother receives it within one minute of delivery of baby 14
