NAME ____________________________ DATE _____/_____/_____ SKILL PERFORMANCE EVALUATION OBSTETRICAL EMERGENCY / EMERGENCY CHILDBIRTH DELIVERY PERFORMANCE OBJECTIVES Demonstrate proficiency in assisting with an imminent delivery and perform initial interventions as necessary. CONDITION Assess and assist in the delivery of a newborn and initiate appropriate interventions as needed using a simulated patient. Necessary equipment will be adjacent to the manikin or brought to the field setting. EQUIPMENT Obstetrical manikin with newborn, placenta and umbilical cord, 1 assistant, obstetrical kit with cleansing towelettes and, 4x4s, drapes, sheet, towels, 2 cord clamps, 2 plastic ties, umbilical cord scissors, bulb syringe, obstetrical pad, plastic bag, sterile gloves, baby blanket, oxygen tank with flow meter, oxygen tubing, adult and neonatal oxygen mask, adult and neonatal bag-valve-mask device, nasal cannula, stethoscope, eye protection, masks, gown, gloves, pillows. SCENARIO: ___________________________________________________________________________________________ EXAMINER(S): ______________________ PASS FAIL Attempt: 1st 2nd 3rd (final) PREPARATION Skill Component Yes Assesses scene safety Establishes body substance isolation (BSI) precautions Assesses mother’s history: LMP and/or EDD Prenatal care Gravida and para Rupture of membranes Vaginal discharge Problems with this pregnancy Multiple births expected Type of previous deliveries Problems with past deliveries Diabetes or Hypertension Prescription Medications Over the counter Recreational Frequency Assesses contractions: Duration Intensity Crowning Determines if delivery is imminent: Contractions 2 – 3 minutes apart Urge to push Bulging perineum Gown/long sleeves Puts on additional protective equipment: Face mask Eye protection Non-sterile gloves Obstetrical Emergency – Delivery (Skill Performance Evaluation) © 2017 Page 1 of 3 No Comments Skill Component Yes No Comments Semi-Fowlers Elevate buttocks 2-4 inches with a pillow Remove clothing from the area Bend knees and spread the legs apart Positions mother appropriately Opens OB kit Cleanses perineum with wipes from front to back (top to bottom) Puts on sterile gloves appropriately Drapes mother creating sterile field around vaginal opening PROCEDURE Skill Component Yes No Comments Applies gentle pressure to the mother’s perineum Prevents explosive delivery by supporting the neonate’s head Ruptures amniotic membranes - if needed Scenario dependent Notes the color AND odor of the amniotic fluid Checks for nuchal cord AND institutes appropriate measures – if indicated Assists in delivering the shoulders Performs a McRoberts maneuver – if indicated Scenario dependent Upper – guide head down Lower – guide head up Hyper-flexes the mother’s legs to the abdomen Applies suprapubic pressure while gentle pulling downward on the neonates head Assists in delivery of the rest of the body Supports the head Holds newborn securely Keeps the newborn at the level of the perineum Places the neonate on the mother’s abdomen Wipes newborn’s mouth AND nose Retractions Clears newborn’s mouth and nose with bulb syringe – if signs of airway obstruction Gurgling Scenario dependent Stridor Apnea Choking Stimulates newborn to breathe if indicated Double clamps umbilical cord Scenario dependent 1 clamp 4 inches from newborn st 2nd clamp 6 inches from newborn or 2 inches from 1st clamp (towards mother) Cuts umbilical cord between clamps Dries and wraps newborn in dry blanket or towel covering the Obstetrical Emergency – Delivery (Skill Performance Evaluation) © 2017 Page 2 of 3 head, to maintain body temperature Skill Component Yes No Comments Directs assistant to monitor and complete initial care of the newborn Assesses mother’s vital signs AND the amount of bleeding Verbalizes the signs of placental separation: Lengthening of the umbilical cord Sudden gush of blood Contraction of the uterus Directs the mother to bear down gently Grasps placenta at vaginal opening Delivers placenta Guides placenta and membranes into bag/basin Checks (inspects) for integrity of the placenta and cord Checks for lacerations and controls bleeding – if indicated Places obstetrical pad(s) or large dressing over perineal area Assesses fundus every 5 minutes and performs fundal massages – if indicated: ADDITIONAL CRITERIA Skill Component Yes Makes appropriate decision based upon reassessment findings

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