This is a thorough assessment of a new born baby by the midwife from head to toe after birth to confirm normality, exclude any congenital abnormalities and medical concerns. It is done initially within 48 hours at birth and before baby is discharged home.
Aims
· Assess APGAR Score (Appearance, Pulse, Grimace, Activity and Respiration)
· Detect acutely unwell neonates who require urgent treatment
· Evaluate and address the family’s concerns about the neonates
· Review the neonate weight and other parameters
· Assess whether urine and meconium have been passed
· Identify any congenital malformations and arrange any required management
· Discuss matters relevant to the neonate with mother (e.g. neonatal care, feeding, vitamin K, Hepatitis B and BCG immunization)
· Explain issues such as jaundice that may arise in the following days or weeks
· Discuss how the family will be able to access additional support if required
· Educate the mother on breastfeeding
· Confirm sex of the baby
Types
· Immediate assessment
· Subsequent assessment
Requirements
A tray containing the following:
a. Sterile gallipot with cotton wool swab
b. Cord ligatures/clamps
c. Stethoscope
d. Pulse oximeter
e. Scissors
f. Measuring tape and gloves
g. Antiseptic lotion
h. Injection Vitamin K (depends on protocol of hospital)
i. Syringe and hypodermic needle
j. Baby dress
k. Cot sheets
l. Diaper
m. Wipes
n. Others (Good light source, flat surface, plastic apron, chairs, sharps container)
Steps
1. Establish rapport to mother (Refer steps)
2. Explain procedure (Refer steps)
3. Collect and assemble all items
4. Prepare a conducive room (close nearby windows, put off all fans and air conditioners if available)
5. Maintain infection, prevention technique throughout the procedure
6. Wear mackintosh apron and perform hand hygiene
7. Put on gloves and collect baby from mother (invite mother to observe procedure if possible)
8. Position baby on a safe flat covered surface
9. Unwrap the baby, do general inspection and cover with a clean sheet
10. Check the neonate temperature
11. Examine baby’s head, face and neck for abnormalities
12. Examine the chest (rise and fall of the chest, symmetry)
13. Check for apical pulse or listen to heart sound
14. Examine the abdomen (distention of the abdomen etc.)
15. Examine the cord for number of vessels and any bleeding
16. Examine the arms and hands for extra digits, webbed fingers, etc.
17. Examine the genitalia (if male; position of urethra opening, undescended testes, if female; abnormal discharges)
18. Test patency of rectum and urethra opening
19. Examine hips for dislocation
20. Examine lower extremities talipes, webbed toes, extra digits etc.
21. Examine the back of the baby (sacral dimple, spinal bifida)
22. Elicit for reflexes (Suckling, Moro, blinking, grasping etc.)
23. Give injection Vitamin K according to hospital’s protocol
24. Dress, wrap and place baby back into cot or sends to mother
25. Express appreciation to mother and communicate findings to her
26. Dispose off used items and decontaminate instruments
27. Perform hand hygiene
28. Record and report findings to the Officer in-charge
0 Comments