Do your docs bring baby to sterile warmer in c/s?

[zinker35861]

We are trialing a new technique for our hospital in which the doc brings the baby to a sterile warmer in a c/s instead of having a nurse gown and glove to receive the baby from the doctor. We did this at the other hospitals I worked for and it always worked well. Many of the doctors and staff members are very skeptical that this is an acceptable practice due to the fact the doctor has to walk about 5-6 ft from the patient to the warmer. Fears of dropping the baby because they might slip on the floor have also been brought up. On the other hand the nurse has not done a sterile scrub and she is directly touching the physician with the baby handoff. We always don't have personnel from our nursery or pp unit who come to help that are willing to gown and glove because they want to be ready at the warmer. So what happens is our circulator ends up gowning and gloving instead sometimes. Saving the cost of the gown and glove during each of our c/s's was also brought up. I just wanted to know what others did at their hospitals. Thanks

[L&DRN03]

It was an old practice at my hospital that the doctor brought the baby to a sterile warmer. We now have a pedictrician at all c/sections and they are the ones that down sterile gloves and gown. I think maintaing sterile technique is more important then saving a few $$ on the cost of sterile gowns and gloves.

[Jolie, BSN]

How do you set up the warmer for possible resuscitation if it must remain sterile? Where do you place your ambu bag, mask, suction catheters and ETTs?

[zinker35861]

We set up the oxygen and the suction and lay them along the back wall of the warmer and drape is pulled enough away from those things so the RN and ped can have access to check them. Blankets are underneath the drape. We have a shelf that is attached to the warmer that we set up our amb bag, ET tubes, larygascope, mec aspirators ect.

[prmenrs, RN]

If the nurse puts a sterile drape over herself, OB can place the baby on that. I don't think OB should walk to the warmer--i.e., he should not leave the table. jmo

You put the drape over yourself like a big napkin--covers your chest and arms, and you have sterile gloves on, too, but you just envelope the baby w/the drape.

When I worked in a teaching hospital, the resident scrubbed up and sterile gowned and gloved.

[hjc3405]

During our c/s the scrub nurse has a sterile drape and sterile baby blanket laid out over the warmer. When it is time for the baby to be taken to the warmer, the nursery personel puts the drape over themselves (keeping it sterile) and walks to the bedside and the dr. sets the baby on top of the blanket. That way the doctor does not take the chance of breaking sterility and he does not have to take more time with the baby, in case the mother needs to be taken care of asap (bleeding, etc..)

[littlepeach]

We too take our own babes. Md's tend to mommy. We gown and glove and carry our babies to the warmers. I don't think OB doc should be leaving the mom either.

[zinker35861]

I appreciate everyones replies to this. Its hard to find anything out their stating you should do it one way or the other. I do get that the doc shouldn't leave the sterile field. Seems that the nurse needs to do a sterile scrub, gown, and glove because technically you are in contact with the physician and if we don't do it why are they doing it? I'm probably making this harder then it has to be but where are the OR standards.

[Canadian_Nurse]

We cover our warmer with a sterile disposable drape, warm blankets underneath, and resus equipment under to one side or on the shelf above. A doc closest to the warmer brings the babe over to the warmer, places them on the sterile drape, and goes back to the OR table. We are a teaching hospital, so there is always a resident and OB at the section, and often the patient's family doctor. We've never had a problem with this system.

[zinker35861]

That's how it was done at the last 2 hospitals I worked at too. Seemed to work well.

[eandgsma]

At my last job we just had a sterile drape over our arms like a big napkin (as someone else described) and the doc handed the baby over. Now we have a "baby nurse" who scrubs, gowns and gloves to catch the baby. I think its overkill. Why not just have the sterile drape that the doc is in contact with?

Now here's another wrench...what about with multiples? When you have someone scrubbed to catch one baby and put that baby down, then you are no longer sterile. You either have to have someone else scrubbed, gowned and gloved OR another person with a drape to catch the subsequent baby(babies). Now THAT could get expensive if you had all those people getting sterile. A sterile drape would work just as well and be more cost effective.

There has to be some sort of study out there on this though. I wouldn't even know where to begin to look though!

- N

[mom2michael, MSN, RN, NP]

Who ever receives the baby (the peds, the baby nurse, whoever) gloves up and uses sterile blankets. You walk up to the table to the right of the doctor (always) and he or she hands you the baby, you come back to the warmer and baby is no longer sterile. I don't get close enough to touch anything (like the drapes over the patient), the doctors gloves touch nothing other than the baby and my sterile baby blanket.

We don't bunny suit up unless we want to because we wear hospital issued scrubs and we don't get close enough to the sterile field. We also don't put on a gown unless we anticipate having to get REALLY close (like say the baby is stuck in the pelvis and we have to apply pressure to the head). In that case our scrub techs are awesome at helping us get sterile (and stay sterile).

It works well - keeps doctors focused on mom and us focused on baby.