This is a continuation of my last blog post titled, “The Standard of Care when a Cesarean Section is Performed in the Delivery of an Infant ~ part 2,” and will be my final blog post on this particular topic this week.
13.) Did the Woman have a Foley Catheter Inserted?
Why is this important? Unlike the emergency situations described in # 12 in my last blog post, when there is a situation that is not an emergency, then, after adequate anesthesia, a Foley Catheter can be inserted to assist with drainage from the bladder during the C-Section and may remain in place for 12-24 hours thereafter.
14.) Were the Patient’s Vital Signs Continuously Monitored During, and Before, the Administration of the Anesthesia?
Why is this important? The Patient’s vital signs such as pulse, oxygen saturation, blood pressure and the like must be monitored during the entire C-Section procedure and must start before the anesthesia is administered.
15.) Did the Patient experience any Intra-Operative Complications such as Hypotension with Bradycardia?
Why is this important? At times, after anesthesia is administered, hypotension that can be severe when bradycardia may occur. If this does happen the commonly used methods to treat or prevent hypotension may include, but are not limited to, pre-loading of fluid, administration of medication, and vasopressor and positioning therapy.
16.) Was the Assistance of a Neonatologist or Pediatrician, or both, called by the Clinician for Assistance?
Why is this important? As I discussed in my blog about the baby who was lacking oxygen prior to the emergency C-Section that resulted in a permanent and severe brain injury, the neonatologist team was called to assist and spent much time in reviving and assisting with the baby to breath. Unfortunately, the lack of oxygen due to the delay in the initial contact of the Dr. to begin the emergency C-Section, according to the Jury, was what caused the permanent and severe brain damage to the fetus.
These Guidelines, however, are not just State guidelines, but International Guidelines relating to pediatric care and neonatal resuscitation and clearly state that a practitioner who is trained appropriately must be present during all C-Section births.
17.) Were any Physical Injuries sustained by the Infant During the C-Section Delivery?
Why is this important? During a C-Section Delivery, there must be diligent precision and care used to make sure that there are no lacerations by instruments used in the procedure. It is important to note that this can be a complication that could be more likely with any membrane ruptures or if oligohydramnios is present.
18.) Was there Documentation after the C-Section Operation of the Mother’s Vital Signs such as Bowel Sounds, Surgical Wound Condition, and Urinary Output?
Why is this important? A very important part of care after surgery is that the vital signs are taken every 15 minutes for at least the first 2 hours and then that the urine output is monitored hourly, that immediately palpation occurs and clots are expressed, and that the surgical wound is examined for any signs of infection along with auscultating of the abdomen to determine that bowel signs return.
19.) Did the Patient Experience any Post-Operative Complications such as an Infected Wound Area?
Why is this important? It should be noted that the wound area be evaluated for tenderness, inflammation, and/or drainage of any material that is unusual.
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Since there are very strict time limits in these types of complicated cases, then please contact us as soon as possible so that we may begin the investigation of your case in a timely manner.