Ashok Raja, J (2014) A Randomised controlled equivalency trial on wiping with a cloth (no suction) Versus routine suctioning of oronasopharynx at birth, in term neonates born elective LSCS with clear liquor. Masters thesis, Madurai Medical College, Madurai.
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Abstract
In ancient times, birth attendants tried to remove the secretions by using a cloth or by blowing through the mouth and nose, or using a finger to remove secretions.(1) Then as the science of Resuscitation started developing, the initial resuscitation practices started from routine suctioning of mouth and nose using a suction machine or bulb syringe. Now the Recent NRP (Neonatal Resuscitation programme) 2011 guidelines states that clear the airway if necessary and it can be done with a suction catheter, bulb syringe or by wiping with a cloth.(2) In Indian context all the three methods are prevalent in different settings throughout the country. WHO and NRHM raised concerns about sterilizing the bulb syringes and the chances of infection using a towel. A Disposable suction catheter or Delee’s mucus trap connected to a suction machine is used in many hospitals including our hospital. Observations on natural birth of mammals showed that, immediately after birth the mother animal licks over the face of the off spring, including the mouth and nose. This naturally wipes out all the secretions, and also gives tactile stimulation to the off spring to initiate breath. These observations bring forth the thought that wiping the face with a clean cloth mimics natural phenomena, licking. 1. Wiping with a sterile towel is equally efficacious with suctioning using a catheter in term neonates born with clear liquor in attaining oxygenation. 2. The time to reach 92%, 85%, 95% saturation levels are significantly lesser in the no suction/wipes group compared to the suction group. 3. The mean saturation levels are significantly higher in the no suction group from 2 to 6 minutes, 9 to 12 minutes and at 14th minute. 4. The proportion of neonates reaching saturation of 85%, 92% and 95% are significantly higher in the no suction group in the early minutes (2, 3, 4, 5 and 7 respectively) after birth. 5. Significantly higher mean heart rates are present in the no suction group at 4th and 5th minute of life. 6. These findings show that routine suction does not have any advantage in the oxygenation at birth, in the present study population. 7. Our study support the Recent NRP recommendation of routine suction is not necessary at birth. 8. Also we don’t find any significant bradycardia or adverse effects with a gentle electrical suction in the group of term vigorous elective Lscs, non meconium stained neonates.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | wiping with a cloth; no suction; routine suctioning of oronasopharynx; neonates born; elective LSCS; clear liquor; A Randomised controlled equivalency trial; |
| Subjects: | MEDICAL > Neonatology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 23 Jun 2017 07:20 |
| Last Modified: | 23 Jun 2017 07:20 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/292 |
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