Initial Birth Exam Flashcards
What are the aims of an initial birth exam?
Assess adjustment to life Sets baseline Confirms normality Detects deviations Reassures parents Opportunity for education Neonatal period = birth to 28 days
What is APGAR
Appearance Pulse Grimace Activities Respiration Score out of 10 1 minute 5 minute Record until stable
Explain the procedure for an initial birth exam
Gain informed consent from parents
Wash hands and wear gloves
Good lighting, access & 1 parent present
Uncover the part examining and recover
Examined methodically & systematically, head to toe
Colour, tone & activity noted throughout
Passage of urine & meconium recorded
Note head circumference, length & weight
Redress baby and ensure identification
Discuss findings with the parents as per NMC Code
Document and act accordingly as per NCM Code
Name some things that should be included in identification
Twin/triplet identification Mothers surname Gender Date & time of birth NHS number Mother & another midwife to check Check daily in hospital
What are we looking for on the skin?
Clear, soft & elastic Vernix present Pink Hand/feet possible acrocyanosis Other cyanosis or jaundice needs referral as per NMC Code
What are we looking for on the head?
Palpate the skull, sutures and fontanelles checking open & soft
Skull bones may overlap due to moulding
Caput succedaneum - swelling
Cephal haematoma - bleeding below posterium
Circumference average 34-35cm
Ears level with eyes
What are we looking for on the face?
Symmetrical 2 eyes level Eyes clear Nose in middle line Nostrils patent Lips & membrane pink Lips, gums, frenulum & palate intact Check sucking and gag reflex Check roof of mouth
What are we looking for on the chest & abdomen?
Symmetrical Check cord Breast & nipple tissue developed Clavicles observed for fractures Resps symmetrical & diaphragmatic Resps: 40-60 Pulse: 110-160 Temp: 36.5 - 37.5
What are we looking for on the spine?
Flat Straight No sacral dimples Blue spots normal in some ethnic groups Weigh naked Average 3.5kg
What are we looking for on the genitalia?
Male: urethral opening, testes descended
Female: appearance, oedematous, skin tags
Position & patency of anus confirmed
What are we looking for in position & movement?
Flexed Limbs equal Five fingers & toes each hand & foot Nails formed Creases on palms & soles Good muscle tone Feet straight Neutral range Normal reflexes
