From the Editor
Transfer to the hospital for women planning a home birth: A high-risk obstetrics problem
Do you have a written clinical guideline for pregnant women planning a home birth who are transferred to your hospital?
Suggestions to boost safety
The patient positioning for minimally invasive procedures demonstrated in Dr. Advincula’s video has worked well for me. However, I would like to offer a few additional maneuvers to increase safety:
- Preoperatively, tell the patient that she will have received intravenous (IV) medication to relieve anxiety before entering the operating room. Explain that she will be placed in stirrups and covered.
- Once the patient is in stirrups, ask if she is comfortable before she receives general anesthesia. This helps to identify pressure points on the lower back.
- Undo the snaps/buttons at the top of the hospital gown and remove the gown from beneath the shoulders to help prevent pressure points on the shoulder girdle.
- Before wrapping and tucking the arms, cut off any plastic clips that control flow from the IV line at the wrist or forearm; the clips are not needed and could potentially cause pressure point injury. Also place a piece of gauze between the arm and IV connections to prevent pressure point injury.
- Prevent calf pressure by placing the heel against the back of the stirrup foot-piece.
Ray Wertheim, MD
Fairfax, Virginia
Share your thoughts on these letters or on another article! Send your Letter to the Editor to rbarbieri@frontlinemedcom.com. Please include your name and the city and state in which you practice.
