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I really should know this, but luckily I have never had a patient with a cord prolapse. When they tell you to put pt. in knee-chest, do they mean like a McRobert's maneuver where the pt. is on their back and the knees are flexed up on the abdomen, or is the pt. suppossed to get in a modified hands-knees position. (I always thought that one would be kind of hard to get them to do when you have your hand up there.) Thanks!
The patient needs to be in a true knee-chest position, with her chest down at the level of the bed and her hips up in the air, so that gravity will allow the baby's head (or presenting part) to "drop away" from the cervix and relieve pressure on the cord.
Also, dont' forget, inserting and backfilling a foley catheter can be very useful, as well, if you know the csection won't be within the next 5 minutes....this is a time when you need a TEAM working the case, and where each nurse KNOWS his or her role and how to play it......
one holding presenting part off of cord....
another getting IV and foley cath and/or prepping pt for surgery
and yet another communicating with MD, House supervisor, peds, etc, and getting appropriate personnel in to handle this emergency.
This is why I think drills are so valuable.
I really should know this, but luckily I have never had a patient with a cord prolapse. When they tell you to put pt. in knee-chest, do they mean like a McRobert's maneuver where the pt. is on their back and the knees are flexed up on the abdomen, or is the pt. suppossed to get in a modified hands-knees position. (I always thought that one would be kind of hard to get them to do when you have your hand up there.) Thanks!
It means patient is on hands and knees, with knees apart, butt up in the air and chest down low.
kcrnsue
91 Posts
I really should know this, but luckily I have never had a patient with a cord prolapse. When they tell you to put pt. in knee-chest, do they mean like a McRobert's maneuver where the pt. is on their back and the knees are flexed up on the abdomen, or is the pt. suppossed to get in a modified hands-knees position. (I always thought that one would be kind of hard to get them to do when you have your hand up there.) Thanks!