Suctioning after birth

  1. 0
    Question...I am studying for my OB exam and I am confused now. I know as soon as the baby emerges, you suction the mouth first and then the nose. This prevents the baby from gasping the fluid when suctioning the nose. Now, if the baby had meconium stain, based on the color of the amniotic fluid, is the suctioning the opposite? Do you suction the nose then the mouth? If this is mec stained, do you use a bulb syringe or an actual suctioning cath for deep suctioning?

    Thanks in advance for any assistance
    -Niesy
  2. 19 Comments so far...

  3. 0
    If there is meconium, there is not to be any suctioning done on the perineum. NICU is usually there to use a delee suction to clean out the muck before it gets below the cords.
  4. 0
    Quote from cc_nurse
    If there is meconium, there is not to be any suctioning done on the perineum. NICU is usually there to use a delee suction to clean out the muck before it gets below the cords.
    I am confused with your response...I was refering to suctioning the newborn. Is that what you are talking about?
  5. 1
    When there is mec present, the baby is usually suctioned before the shoulders are delivered by the OB then handed to the NICU team- the baby is not stimulated so as not to encourage it to take a big old gasp of mec- then they baby is placed on the warmer, the cords are visualized and the baby is suctioned WELL at that time with a mec aspirator(usually) or a large suction cath(10fr). Sometimes they will do more than one pass. THEN the baby is stimuated/dried and the nose is suctioned out. There should not be any suctioning before the cords are visualized.
    NiesyLuv0o likes this.
  6. 0
    Thanks PICNICRN. Therefore the nose is suctioned first. When you say the cords...what do you mean? The cord attached to the placenta (meaning the first suction) or the cord when the baby (cord is cut) is under the warmer (subsequent suctions)?
    Thank you
  7. 1
    vocal cords
    NiesyLuv0o likes this.
  8. 0
    haha...gotchya...the vocal cords to intubate and do a deep suctioning I suppose. Sorry, I did not understand...i only have 6 weeks of OB and this is my final week and an exam.
    Thanks a lot!
  9. 1
    According to NRP protocol, if there is mec staining and the baby is not vigorous, intubation and endotracheal suctioning is indicated. However, if the mec is thin and the baby has good muscle tone, respiratory effort, and color, you can proceed with the normal initial steps following the delivery of a potentially compromised newborn (drying, warming, suctioning mouth then nose, and stimulating to breathe).
    NiesyLuv0o likes this.
  10. 0
    Er, in other words, basically everything that PicnicRN said...
  11. 1
    Exams will probably require you to say "suction at perineum", but you may not see that, because latest research shows it no longer changes outcome, and the trend is slowly changing.
    Apgar10 likes this.


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