02. Guide to UMHL

Last updated on 03/07/2023
Working Hours Wards
Mon - Thur 08.00 - 17.00

M1 & M2 Postnatal

M3 Antenatal

Friday 08.00 - 16.00


Intern Jobs:

  • Get the list everyday from the midwives on the Postnatal wards.
  • Prepare discharges for that day.
  • Ensure Day2 LSCS have FBC.
  • On Friday, prepare discharges for the SHOs over the weekend.
  • There is no bleep for the interns.
  • You will be called on your mobile.
  • Leave bloods out in the evening (for phlebotomy the next day).

 


Discharge:

  • SVD day 2
  • Kiwi/Forceps day 2 or 3
  • LSCS day 4 or 5 (any less, needs Reg review)
  • You need to fill out discharge summaries for the charts
  • PICOs come off day 7 - PHN usually removes.
    • Also document if staples were used (located in Op notes).
    • GP follow up in 6 weeks.
  • Standard analgesia for one week (no oxycontin/oxynorm etc).
    • Please prescribe an additional PPI if giving Difene.
  • Check the VTE score and prescribe prophylaxis if required.
  • Gynae referral needed if 3/4 degree tear.
    • They will see the same consultant in clinic in 6 weeks.
    • If there is follow up for cysts/fibroids, same process with the exception that Prof Cotter’s patients will see Mr. Hickey. 

Notes in chart:

  • Day _ post SVD / LSCS of live M / F infant 
  • VTE / IMEWS
  • Pain 
  • Breast / Bottle feeding
  • Rubella / Rh status - if not immune for vaccine in GP.

 


Other Info:

  • Cannulation - green/grey line essential in antenatal women (risk of PPH).
  • Consent is a SHO/REG job.
  • Hb <8, transfuse patient and give IV Ferrinject.

 


Bloods:

  • LCSC - FBC, G+H
  • ERPC - G+H
  • PET - FBC, Coag, U+E, LFTs, Uric Acid
  • Booking - FBC, G+H, VDRL, Rubella, HIV, Hep A/B/C
  • ToP - FBC, Coag, G+H 

 


Common Medications

Don’t forget the Mat section in the Micro Guide.

Pre-theatre:

  • H2-blocker (check with team) and Sodium Citrate 30ml PO (Stat)

Analgesia:

  • Diclofenac 100mg PR (effective for 16 hours) 
  • Diclofenac 50mg PO TDS (max 150mg in 24 Hours)
  • No NSAIDS antenatally
  • Paracetamol 1g PO QDS
  • Tramadol 50mg PO TDS
  • Pethidine 50 - 100mg IM 4 - 6 hourly
  • Oxycontin 10mg PO BD / Oxynorm 5 - 10mg PO PRN/QDS 

Stemetil - 12.5mg IM
Ferrinject 1g in 250ml NS 0.9%
Betamethasone 12mg IM x 2 doses
Colpermin 1 - 2 TDS
Topical PRN/QDS

Any questions do not hesitate to ask the Midwives/ SHOs/ Regs