Appendix 1

Normal Values Of Coagulation Tests

Appendix 2

Contents Of Resuscitation Kit

• Laryngoscope with cells.
• Mac 3, 4 blade of laryngoscope.
• Ambu bag with mask, valve, reservoir bag , mask no -3,4.
• Mouth gag.
• Hudson mask.
• Tubing for oxygen delivery.
• Endotracheal tube no.- 6.5,7,7.5.
• Airways no. – 3,4.
• Torch with cells.
• Suction catheter .

Drugs

• Atropine – 10 amp.
• Adrenaline – 10 amp.
• Soda-bicarbonate -10 amp.
• Aminophylline – 4 amp.
• Hydrocortisone - 4 amp.
• Dexamethasone – 4 amp.
• Dopamine – 4 amp.
• Noradrenaline – 2 amp.
• Deriphylline – 4 amp.
• Calcium gluconate – 2 amp.

Appendix 3

Confirmatory Test

A) Premature Rupture Of Membranes- (PROM)

1. Litmus test- Red litmus paper turns blue when it comes in contact with amniotic fluid.

(Test is false positive in presence of antiseptic solution, urine, blood, vaginal infection).

2. Nitrazine test - (if available) Nitrazine paper turns blue if vaginal fluid is alkaline. If membranes are intact the paper remains yellow.

(Test is false positive in presence of antiseptic solution, urine, blood, vaginal infection).

3. Fern test- Collect endocervical fluid and make a smear. Allow the slide to dry and examine under microscope. Ferning will be seen in presence of amniotic fluid.

(Test is false positive in presence of cervical mucous).

4. Evaporation test- Collect vaginal fluid / endocervical fluid on a glass slide and heat it until water content evaporates. If there is white residue--- it is amniotic fluid

5. Microscopy of fluid- Shows lanugo hair, epithelial cells, vernix in presence of amniotic fluid.

6.Nile blue sulphate test- Vaginal fluid / endocervical fluid mixed with nile blue sulphate gives orange colour.

B) To differentiate between maternal and fetal blood- as in vaginal bleeding.

• Do MCV - Fetal MCV is always higher than maternal MCV.
• KOH Test- Add 5 ml tap water to 3 drops of blood. To that add 6 drops of 10% KOH, it turns red within 2 minutes in presence of fetal cells. It turns brown within 2 minutes in presence of maternal cells.

Rules Of Handing Over Of Duty

• At 7 a.m. registrar of previous emergency unit has to give complete over of labour ward and waiting ward to registrar of next emergency unit and the latter should write findings on paper.
• Registrar of emergency unit should take over of resuscitation kit , fetal monitors , and suction machine.

The decision on the management of patient in labour ward during OPD and OT hours should be taken by the emergency unit and then the parent unit should be informed about it.