Recommendations for delayed first stage 1.inform senior midwife and obstetrician 2. Obstetric review within 40minutes 3 discuss augmentation with obs team 4. Amniotomy with consent 5 oxytocin augmentation as prescribed by obstetrician 6 . Continuous cardiograph to monitor feta heart rate and contraction 7. Explain situation and reassure mum 8. Perform vaginal examination after 2 hours of amniotomy 9 . Encourage hydration, light diet, bladder emptying 10. Monitor pulse and respiration hourly, blood pressure, temperature , urine, oxygen saturation 4 hourly 11. Assess pain score and discuss pain management options with her including epidural 12 1-1 in labour ward 13. Assist her assume comfortable and appropriate position avoiding supine. Please Annita, can you check for me?
Hi Anita. this is my recommendation for labour: 1. Inform the senior midwife. 2. Inform the obstetrician for review and to prescribe pain relief. 3.Reassure the patient. 4. Continue monitoring ( CTG). 5. Encourage hydration. 6. Regular bladder emptying. 7. Exercise. 8. Continue maternal observations. 9. Monitoring of contractions (1/2 hourly). 10.Take Blood samples for FBC, CPR, Liver function etc. 11. Cannulate patient. 12. urine for urinalysis or send to the lab. 13. Monitor fetal movement. 14. Four (4) hourly vaginal examination. I did the recommendation on mine own before I will look to the NICE guideline. Please Anita have a look and tell me where to improve and I will do the same for Postnatal and send it to you. Thank you for all your time.
You cannot continue ctg,you need to commence CTG to assess fetal wellbeing and contraction The maternal observation have separate timings,bp and temp every 4hours,pulse hourly Cancel monitor contraction be as she is already on ctg You cannot cannula the patient yet,it’s unsafe,please cancel the point Vaginal examination is 2hours to diagnose slow progress of labour and perform amniotomy Then repeated 2hours again and if the labour is still slow,consider oxytocin augmentation No need for urinalysis,please cancel Monitor fetal movement,this is already on ctg so cancel the points It is unsafe to take bloods in labour APIE,so please cancel the points New points to use: Involve woman in her care Provide feedback or assessment to patient and allow her to ask questions Support her to make informed decisions Record findings on partogram Discuss pain relief options and administer prescribed analgesics
Hi Anita,this is my recommendations for the labour 1. Inform the senior midwife on duty. 2. Inform the woman about her progress of labour 3. Inform the obstetrician to review the woman. 4. Support the woman choice 5. Encourage hydration 6.Regular emptying of the bladder. Reassure the woman and involve birth companion or partner 7.Continue Bp,respiration and oxygen saturation and pulse every 4 hours 8. Monitor fetal heart rate everyone 30 minutes 9. Monitor contraction every 30 minutes 10.Perform urinalysis 11. Perform urinalysis 12. Encourage the woman to say if she wants analgesia at any point in labour
Point 7,the correct answer is check BP and temp every 4 hours and pulse hourly Cancel point 8 and write commence CTG to assess fetal wellbeing and contractions Point 10 and 11 is not necessary 12)rewrite it as :discuss pain relief options and administer prescribed analgesics There is more u can add
Sweetheart you have been such a blessing to some of us. Your channel really helped me to pass cbt. Am preparing for osce now but am very confused with all this, just to enquire if you have or know any good training and mock center you can recommend. Thanks
Thank you so much for all of these videos they have been so helpful. I am practicing for a resit and have a question regarding implementation station. If co-amoxiclav is charted as 625mg but the bottle dose is written as 500mg/125mg does that mean the prescription is incorrect and should not be given?
It’s mean the proscription is correct what 500mg/125mg means is that,(co-amoxiclav is a combination of two drugs which is amoxicillin 500mgand clavulanic acid 125mg) so when the drugs comes together as co- amoxiclav then you add 500mg and 125mg to become 625mg so 500mg/125mg is the same as 625mg
Hi Anita, your channel has been really helpful ❤ Please could you clarify the planning labour and birth APIE for me ?? Point 5. says that, recommend appropriate timeframe for medical review.. what does it imply please?? Thank you 🙏
Hi Anita Could you plz check my planning for delay in first stage of labour: 1- Inform senior midwife and obstetrician to review Gemma. 2-Inform Gemma in her birth plan and involve her in planning of her care. 3-Ensure she is on continuous topographic monitoring to check fetal wellbeing and contractions. 3-Check maternal observation every 4 hourly and pulse every hour. 4-Provide psychological support and also provide pain relief. 5-bladder care: ensure passing urine and measured. 6-Discuss and perform with consent amniotomy, noting the liquor. 7-perform vaginal examination 2 hous after amniotomy and then 4 hourly to note progress, if delay transfer to obstetric led care. 8-Consider augmentation of labour with oxytocin infusion until regular contractions 3 to 4in 10 min achieved. 9-Inform theatre and consider caesarean section if there is no progress 10-Encourage fluids, isotonic, and light diet. 11- Encourage mobilisation and change positions 12- using balls, mats, bed to accommodate this.
My recommendation for Postnatal: 1. Inform the senior midwife. 2. Reassure the patient. 3. Breast feeding support. 4. Perineal exercise. 5. Encourage hydration. 6. Encourage good diet. 7. Regular taking of medication. 8. Regular emptying of bladder and bowel. 9. Encourage to have good sleep and rest. 10. Encourage to seek for help for any concern about her or baby or to call the help line. 11. Explain to her about anxiety, depression and postnatal blues during postnatal period. 12. Explain to her change in uterus, breast and lochia and to seek help for any changes. 13. Explain to her about her baby feeding, skin colour, cord, bathing, safe sleep and jaundice etc.
U cannot offer breastfeeding support,u need to support her feeding options because not every mother breastfeeds Point 12 can be just assess lochia Good point ,how about u give me point on engorgement,cracked nipples and perineal infection
Please in the labour planning when writing the assessment do I need to write everything they had done previously on the partograph or I need to write the short one they write on the scenario paper
No please there are only 5approved centers in the uk and that is only where u can come and write and u will need to apply for a visitor visa in order to travel to write the exams
Thank you very much Anita for your videos, they are of great help to me as I prepare for my OSCE. GOD bless you
You are so welcome!
Intelligent woman...God bless you
We still got our class🎉
Thank you Anita.
Nice presentation and i am waiting for the implementation station. God bless you 🙏
Very soon
Good blessing and giving you more strength and knowledge.
I appreciate that
Thanks
Welcome
Recommendations for delayed first stage
1.inform senior midwife and obstetrician
2. Obstetric review within 40minutes
3 discuss augmentation with obs team
4. Amniotomy with consent
5 oxytocin augmentation as prescribed by obstetrician
6 . Continuous cardiograph to monitor feta heart rate and contraction
7. Explain situation and reassure mum
8. Perform vaginal examination after 2 hours of amniotomy
9 . Encourage hydration, light diet, bladder emptying
10. Monitor pulse and respiration hourly, blood pressure, temperature , urine, oxygen saturation 4 hourly
11. Assess pain score and discuss pain management options with her including epidural
12 1-1 in labour ward
13. Assist her assume comfortable and appropriate position avoiding supine.
Please Annita, can you check for me?
Point 2 is 30 not 40 min
Point 4,your discussion should be with the patient about ur finding
Thanks so much for the prompt feedback. God bless you so much
How many of this recommendations are expected in an exam condition?
congratulation
Thank u
Hi Anita.
this is my recommendation for labour:
1. Inform the senior midwife.
2. Inform the obstetrician for review and to prescribe pain relief.
3.Reassure the patient.
4. Continue monitoring ( CTG).
5. Encourage hydration.
6. Regular bladder emptying.
7. Exercise.
8. Continue maternal observations.
9. Monitoring of contractions (1/2 hourly).
10.Take Blood samples for FBC, CPR, Liver function etc.
11. Cannulate patient.
12. urine for urinalysis or send to the lab.
13. Monitor fetal movement.
14. Four (4) hourly vaginal examination.
I did the recommendation on mine own before I will look to the NICE guideline.
Please Anita have a look and tell me where to improve and I will do the same for Postnatal and send it to you.
Thank you for all your time.
You cannot continue ctg,you need to commence CTG to assess fetal wellbeing and contraction
The maternal observation have separate timings,bp and temp every 4hours,pulse hourly
Cancel monitor contraction be as she is already on ctg
You cannot cannula the patient yet,it’s unsafe,please cancel the point
Vaginal examination is 2hours to diagnose slow progress of labour and perform amniotomy
Then repeated 2hours again and if the labour is still slow,consider oxytocin augmentation
No need for urinalysis,please cancel
Monitor fetal movement,this is already on ctg so cancel the points
It is unsafe to take bloods in labour APIE,so please cancel the points
New points to use:
Involve woman in her care
Provide feedback or assessment to patient and allow her to ask questions
Support her to make informed decisions
Record findings on partogram
Discuss pain relief options and administer prescribed analgesics
@@dankgh_ pls which study materials can we get all this information
Hi Anita,this is my recommendations for the labour
1. Inform the senior midwife on duty.
2. Inform the woman about her progress of labour
3. Inform the obstetrician to review the woman.
4. Support the woman choice
5. Encourage hydration
6.Regular emptying of the bladder.
Reassure the woman and involve birth companion or partner
7.Continue Bp,respiration and oxygen saturation and pulse every 4 hours
8. Monitor fetal heart rate everyone 30 minutes
9. Monitor contraction every 30 minutes
10.Perform urinalysis
11. Perform urinalysis
12. Encourage the woman to say if she wants analgesia at any point in labour
Point 7,the correct answer is check BP and temp every 4 hours and pulse hourly
Cancel point 8 and write commence CTG to assess fetal wellbeing and contractions
Point 10 and 11 is not necessary
12)rewrite it as :discuss pain relief options and administer prescribed analgesics
There is more u can add
@@dankgh_Thank you
Sweetheart you have been such a blessing to some of us. Your channel really helped me to pass cbt. Am preparing for osce now but am very confused with all this, just to enquire if you have or know any good training and mock center you can recommend. Thanks
Yeah, I need one as well
She is the best to contact for the OSCE preparation. She is a certified trainer
We offer virtual only training,glad the CBT was helpful,congrats on ur success
How do I contact you please
Email us on dankcbt@gmail.com
Thank you so much for this video
Welcome 😊
Thank you so much for all of these videos they have been so helpful. I am practicing for a resit and have a question regarding implementation station. If co-amoxiclav is charted as 625mg but the bottle dose is written as 500mg/125mg does that mean the prescription is incorrect and should not be given?
It’s mean the proscription is correct what 500mg/125mg means is that,(co-amoxiclav is a combination of two drugs which is amoxicillin 500mgand clavulanic acid 125mg) so when the drugs comes together as co- amoxiclav then you add 500mg and 125mg to become 625mg so 500mg/125mg is the same as 625mg
Thank you!
Hi Anita, your channel has been really helpful ❤ Please could you clarify the planning labour and birth APIE for me ??
Point 5. says that, recommend appropriate timeframe for medical review.. what does it imply please??
Thank you 🙏
Yes so the NICE guidelines recommend requesting immediate obstetric review within 30min n need to be part of your point for planning recommendations
@@dankgh_ thank you
Hi Anita
Could you plz check my planning for delay in first stage of labour:
1- Inform senior midwife and obstetrician to review Gemma.
2-Inform Gemma in her birth plan and involve her in planning of her care.
3-Ensure she is on continuous topographic monitoring to check fetal wellbeing and contractions.
3-Check maternal observation every 4 hourly and pulse every hour.
4-Provide psychological support and also provide pain relief.
5-bladder care: ensure passing urine and measured.
6-Discuss and perform with consent amniotomy, noting the liquor.
7-perform vaginal examination 2 hous after amniotomy and then 4 hourly to note progress, if delay transfer to obstetric led care.
8-Consider augmentation of labour with oxytocin infusion until regular contractions 3 to 4in 10 min achieved.
9-Inform theatre and consider caesarean section if there is no progress
10-Encourage fluids, isotonic, and light diet.
11- Encourage mobilisation and change positions
12- using balls, mats, bed to accommodate this.
My recommendation for Postnatal:
1. Inform the senior midwife.
2. Reassure the patient.
3. Breast feeding support.
4. Perineal exercise.
5. Encourage hydration.
6. Encourage good diet.
7. Regular taking of medication.
8. Regular emptying of bladder and bowel.
9. Encourage to have good sleep and rest.
10. Encourage to seek for help for any concern about her or baby or to call the help line.
11. Explain to her about anxiety, depression and postnatal blues during postnatal period.
12. Explain to her change in uterus, breast and lochia and to seek help for any changes.
13. Explain to her about her baby feeding, skin colour, cord, bathing, safe sleep and jaundice etc.
U cannot offer breastfeeding support,u need to support her feeding options because not every mother breastfeeds
Point 12 can be just assess lochia
Good point ,how about u give me point on engorgement,cracked nipples and perineal infection
Hi Anita,please for the background, assessment and recommendations, should bullet point be used to indicate new points or how
Please use only bullet points in recommendation
Please in the labour planning when writing the assessment do I need to write everything they had done previously on the partograph or I need to write the short one they write on the scenario paper
You write the initial assessment that has the vaginal examination plotted all together which was done 4 hours agao
@@dankgh_ Owk…. So I do not need to write the contraction, vital signs and the others?
This is everything I need.
I can’t wait to know ur success
Please how can I join your classes
So please if the histories are plenty...do we write everything on the background ?
Everything,if u leave some out,just know u have failed
Thank you for this, really helpful.
Ive emailed you, please.
Will feedback please
Hi .. pls is Osce written in Ghana
No please there are only 5approved centers in the uk and that is only where u can come and write and u will need to apply for a visitor visa in order to travel to write the exams
@@dankgh_ okay thanks
Hello
I sent an email about two weeks now but no reply
Will track your email and reply as soon as it is
Can you please resend so we are able to reply as I am unable to see any unresponded messsage
Temp, pulse, resp, Bp, Spo2... please what is the point 6??
Capillary refill time