⬆️ Normal labour & #management of each stages

Ref; Kedah O&G protocol

So today we'll focus on management of 1st stage of labour ie intrapartum management;

All these plan are HO #responsibilities at PAC, antenatal wards & LR (labour room)

🤰Intrapartum management
(during 1st stage of labour)

🌟according to VenOMMS 🌟


1️⃣ Plot #partogram & T/O LR

[Ventilation]


[Oral intake] 🔽🔽🔽

2️⃣ Allow sips of CF (clear fluids)

3️⃣ Insert large bore branula & start IVD NS/HM/Dextrose Saline; 125cc/hour

❗️In PIH patient; only 1cc/kg/hr (risk for APO) & use only NS ‼️

❗️In Diabetic patients; if DXT less than 7mmol/litre, use D5% solution instead of NS ‼️


[Monitoring] 🔽🔽🔽

4️⃣ V/S monitoring hourly

✔️If PIH in crisis, every 15-30 mins
✔️add on GM monitoring in GDM patients


5️⃣ CTG #monitoring (tracing on admission & post ARM), then to repeat accordingly based on risk factor

6️⃣ Time #contraction; aim good contraction (4:10 in primid, 3:10 in multipara)

7️⃣ NRVE in ? hour (according to current V/E findings)

8️⃣ 1 to 1 care (if enough LR personnel)

9️⃣ Husband/#companion to accompany during labour (not available during pandemic 😷 )


[Medication] 🔽🔽🔽

🔟 #Analgesia if strong contraction

1️⃣1️⃣ For Pitocin #augmentation 1 or 2 hour post ARM if contraction inadequate ( <4:10 in primid, <3:10 in multipara)

1️⃣2️⃣ DIK regime (for GDM patients)


[Special Order] 🔽🔽🔽

1️⃣3️⃣ Amniotomy ie #ARM (if membrane intact)

Source;  ❤️ Medicorp’s O&G #online course❗️local LR protocol varies

Need further reading on the topic?

Download Ampang HO guide for FREE here; https://t.me/nota_perubatan/164

Download Ampang HO guide for FREE here; https://t.me/nota_perubatan/164

Already choose your hosp via E-placement?

But unsure what to #expect & prepare for the next posting, or HOship as general?
.

Enroll for #Departmental Welcoming session NOW at Medicorp’s Teachable school;
https://medicorp-class.teachable.com

You will learn;

✅ HO role in each posting,

✅ must-know #diseases for each posting; the common cases & #emergencies

✅ few case discussions as kickstart #revision for each posting!
.

It’s FREE with unlimited access so that you can learn whenever you want!

Download HO #logbooks here & get to know all the compulsory topics & procedures for HO in each posting;
https://t.me/+zt4DsADauzdhZjE1

Alternatively, you can get the #physical HO #logbook_compilations by Medicorp here;

https://medicorp.onpay.my/order/form/bookstore

✅ 18 in 1 HO logbooks #compilations;

Guide on HO #assessment format & compulsory procedures and topics for HOs.

Recommended for all med grads so you know what to #prepare before HOship ✅

What to expect on 1st day as HO in the #ward?

Can I adapt during #tagging & cope with the work load? 😷
.

How to cover all patients during rounds? 😅
.

How to clerk & #manage cases properly?

How to #present cases smoothly? 😉
.

How to #study for offtag assessment?

Let's learn all these at #online ⚡Flash HO Induction with Dr Iliana,

This Monday, 27th January from 9AM - 5PM 🌟
.

Register for FREE for the LIVE session here; https://medicorp.onpay.my/order/form/freeliveflash0125

Few final seats available for #physical Clinical Skills Workshop before PTM on 17th Feb soon 😷
.

Let's practice our hands on skills on common procedures for HOs;

https://medicorp.onpay.my/order/form/clinicalskillsuturing_workshop

Jauhlah,

& tak sempat nak join Clinical Skills #workshop? 🤭
.

No worries, boleh belajar common procedures dari #smart Clinical Skills Guidebook Medicorp ni,

ada QR codes to demonstration #video of the procedures 🎥
.

(Yg join Clinical Skills #workshop akan dapat guidebook & revision cards waktu program nnt) 😉

Starting from today till March,

all purchase of Clinical_Skills #Guidebook and/or HO #Logbook Compilations

will receive these 3 physical cards to aid your revision before HOship (worth RM 23.70) for FREE 🌟🌟🌟
.

Get your books & freebies here;
https://medicorp.onpay.my/order/form/bookstore

Nak tanya few #questions if senior tak keberatan untuk jawab bila2 free ☺️

1. How many days of hospital #orientation dan bila kami boleh tahu first posting kami ya?

📍 biasa 5 hari.. yg lepas2 ada 3 hari.. posting akn diberitahu masa orientasi nanti

2. ⁠Can we #choose your 1st department or dah susun siap ? If yes, what are the recommended department to start with?

📍 setakat ni tak leh pilih 🤣 kalau boleh pilih, pilih la yg relax dulu e.g: ortho utk adaptation dgn system hospital & cara kerja

📍 kalau nak byk belajar, amik medical dlu.. tapi busy & penat la

3. Boleh kami tahu format of nametag & chop, other recommended #books & things to buy before start tagging later ?

📍just baca short notes yg senior2 share.. setiap department akn ada notes2 dia.. kalau nak baca buku mmg tak sempat, kena byk belajar time round
📍kalau medical blh baca #cpg
📍beli pen hitam je byk2 🤣

4. ⁠barang macam mini calc, pulse oximeter, buku sarawak handbook memang kerap guna atau no need to buy awal2 ?
📍medical: elok beli pulse oximeter, tendon hammer.. letak dlm pocket sokmo
📍paeds: mini calc
📍buku sarawak handbook blh guna for common acute management.. sesuai kalau dduk di medical & ed

Kalau ada houseman lain nak tambah soalan dialu-alukan ya.

Medical :
Pulse oximeter kalau ada sangat bagus - senang round tapi oximeter senang hilang
Stetoskop - sila letak tag nama dan engraved, jgn bg MO pinjam. Kalau MO pinjam makesure dia bg balik

Utk tmbh knowledge :
Baca #CPG dan apply during rounds

Utk biasakan diri dgn kerja
- belajar flow buat kerja ikut urgency

⬆️ conversation with senior HOs in the #hospital WhatsApp group ✅
.

For all HOs included in 1st PTM,

✅ please make full use of the group to ask questions about your hospital to your senior HOs

QR Dengue Infection PDF Final.pdf

For those joining the #online⚡Flash HO tomorrow, please read up & revise this national CPG (Clinical Practice Guideline) for #Dengue;

https://www.moh.gov.my/moh/resources/penerbitan/CPG/QR%20Dengue%20Infection%20PDF%20Final.pdf

Pages to focus on ⤵️