Uterus ruptures at home: My most memorable experience of a transferred home birth
Letters from readers
Featured letters:
– Uterus ruptures at home
– A perfect candidate for home birth?
– Why women choose out-of-hospital birth
– Additional tips for vaginal hysterectomy
– Why does vaginal hysterectomy have to be so complicated?
– Suggestions to boost safety in patient positioning for MIGS
Suggestions to boost safety
The patient positioning for minimally invasive procedures demonstrated in Dr. Advincula’s video has worked well for me. However, I would like to offer a few additional maneuvers to increase safety:
- Preoperatively, tell the patient that she will have received intravenous (IV) medication to relieve anxiety before entering the operating room. Explain that she will be placed in stirrups and covered.
- Once the patient is in stirrups, ask if she is comfortable before she receives general anesthesia. This helps to identify pressure points on the lower back.
- Undo the snaps/buttons at the top of the hospital gown and remove the gown from beneath the shoulders to help prevent pressure points on the shoulder girdle.
- Before wrapping and tucking the arms, cut off any plastic clips that control flow from the IV line at the wrist or forearm; the clips are not needed and could potentially cause pressure point injury. Also place a piece of gauze between the arm and IV connections to prevent pressure point injury.
- Prevent calf pressure by placing the heel against the back of the stirrup foot-piece.
Ray Wertheim, MD
Fairfax, Virginia
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