Office emergency delivery kit

[Megnorth]

Where would I find guidlines/requirements/protocols for what is required to have on hand for emergency OB office deliveries?

As a free standing OB/GYN clinic what are we required to do in the event of a precipitous delivery in the office?

Are we bound by any 'laws' or rules to have certain delivery equipment available?

Do we need more than some blankets,bulb syringe and cord clamps?

Would we be expected to start an IV on the mother in the event of a hemorrhage?

Where would I find this information?

Thanks!

[JustBeachyNurse, LPN]

When I was an EMT we purchased pre-assembled emergency delivery kits (they also had a version for multiple births). As basic EMT's we were not permitted to start IV's as that is/was an ALS skill. The primary idea was to deliver only if we REALLY had to (i.e. baby was crowning) otherwise code 3 to the hospital with notifying staff of impending delivery and beat feet to the L&D with trained, waiting staff.

As far as requirements check with your accrediting agency. dept of health, local public health dept to determine what your obligations are if any. We had two clinics in our immediate area, if a patient arrived in what was thought to be labor 911 was called for transport to the hospital unit if the patient was unable to travel by private vehicle. None of the local clinics were prepared to start IV's in the clinic, if a patient was showing signs of shock, hemorrhage, dehydration etc. the 911 center would dispatch ALS units per protocol (paramedics with training in PALS, prehospital delivery complications, etc.) who were able to start IV's, administer medications under direction of an ER physician.

[Hushi05]

I don't know of any protocols or legal requirements. But I would think you'd want pitocin (can be given IM) and O2 masks for mother and baby. Is your staff NRP certified? Otherwise, I would think your main job is to keep mom and baby warm and call 911.

[MKS8806]

I don't know about office deliveries, but our precip delivery packets have sterile towels, sterile gloves, kelly clamps, cord clamp, and bulb syringe. We would always start an IV, however, that is not always achieved before delivery. We always run Pitocin after deliveries IV, but, as mentioned before, this can be given IM as well. We generally do not do anything with cutting the cord or delivering the placenta until the physician arrives....which is generally within a few minutes following the delivery.

Keeping baby warm is essential. The O2 mask was a good idea for mom and baby as well. I would also probably have a delee handy for suctioning if you have the hookups for wall suction.