Tech in Surgery Prep / Unit 29 TSC 706 review, 2 to 3 minutes
Case Five: A Cesarean Birth
The idea
A worked example, constructed for this course, follows a scheduled cesarean birth, a surgery with two patients.
In practice
The maternal-newborn textbook lists the preparation for a scheduled cesarean: verifying the patient's name, allergies and the reason for the cesarean, confirming the consent, and documenting pregnancy complications. The patient's vital signs and the fetal heart rate are checked. An IV is started before the regional anesthetic. Compression devices go on the legs, a grounding pad is applied, and a urinary catheter is inserted. The fetal heart rate is checked again before the procedure starts. Taylor, the scrub person, has set up the cesarean instruments and counted with the circulating nurse. The abdomen is prepped with antiseptic, and the team takes a time out. The patient's partner is allowed to be present, and the team asks about any birth preferences. The surgeon makes the incision and delivers the baby. When possible, the baby is placed skin-to-skin with the birthing parent or the partner, while still in the operating room. Taylor stays focused on the field: there are two patients, and the surgery on the birthing parent continues after the birth. The uterus and the abdomen are closed, and the closing counts are correct. In recovery, the partner is allowed to stay, the baby is placed skin-to-skin again, and breastfeeding can begin within the first hour.
Where people slip
Pregnancy means two patients, and the preparation reflects it, from the fetal heart rate checks to the support for the family. For the scrub person, the counts and the sterile field matter as much after the birth as before it, because the parent's surgery is not finished when the baby is born.
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