Managing Complications in Pregnancy and Childbirth: - IAWG

C-22 General care principles- wearing utility gloves;- transporting solid contaminated waste to the disposal site incovered containers;- disposing of all sharp items in puncture-resistant containers;- carefully pouring liquid waste down a drain or flushable toilet;- burning or burying contaminated solid waste;- washing hands, gloves and containers after disposal ofinfectious waste.STARTING AN IV INFUSION• Start an IV infusion (two if the woman is in shock) using a largebore(16-gauge or largest available) cannula or needle.• Infuse IV fluids (normal saline or Ringer’s lactate) at a rateappropriate for the woman’s condition.Note: If the woman is in shock, avoid using plasma substitutes(e.g. dextran). There is no evidence that plasma substitutes aresuperior to normal saline in the resuscitation of a shocked womanand dextran can be harmful in large doses.• If a peripheral vein cannot be cannulated, perform a venous cutdown(Fig S-1, page S-3).BASIC PRINCIPLES FOR PROCEDURESBefore any simple (nonoperative) procedure, it is necessary to:• Gather and prepare all supplies. Missing supplies can disrupt aprocedure.• Explain the procedure and the need for it to the woman and obtainconsent.• Provide adequate pain medication according to the extent of theprocedure planned. Estimate the length of time for the procedureand provide pain medication accordingly (page C-37).• Place the patient in a position appropriate for the procedure beingperformed. The most common position used for obstetricprocedures is the lithotomy position (Fig C-1, page C-22).