Skype Training Session for SRI Community Health Workers Date : 8th Nov 2013; Friday Time : 2:30- 3:30 pm Session Number: 2(11/2013) Instructor: Dr. Ambreen N Haq Attendees: Community Health Workers Location : SRI Office .Saidu Sharif Swat Facilitators : Mr. Sardar khan, Mr. Irfan Ali
SUBJECT: POST NATAL CARE (SESSION-I) Summary General: Definition Aim of the visit Visit outline: Greeting, what to look for? General and specific advice Myths and taboos regarding Postnatal period. Specific : What to look for in history and examination and Episiotomy care, Cord care DETAILS : DEFINITION: “A postpartum period (or postnatal period) is the period beginning immediately after the birth of a child and extending for about six weeks. Less frequently used is the term puerperium” Urdu it is chilla , in pukhto it is salwekhti
It is the time after birth, a time in which the mother's body, including hormone levels and uterus size, returns to a non-pregnant state. Lochia is post-partum vaginal discharge, containing blood, mucus, and placental tissue. EXPLANATION:
The postpartum time period, also called the puerperium, lasts from delivery of the placenta until 6 to 12 weeks after delivery. Most of the physiologic changes in pregnancy will have returned to pre-pregnancy physiology by 6 weeks. However, many of the cardiovascular changes and psychological changes may persist for many more months AIM OF THE VISIT: 1. To detect any serious problems which require urgent attention, like fits, severe anemia, severe depression, wound infection, sepsis etc 2. To inform of Do`s and Dont`s VISIT OUTLINE
• Greeting: Salam, show kindness, friendliness, and empathy if there is some thing
• Ask for current issues or problems.
• Look for : GENERAL WELL BEING : Ask your self by looking at the patient : Does she look well? Is she responsive? Is she looking well and is she happy? Is she crying and irritable? Is she coping with additional responsibility? Is she eating well, what is she eating? Is she bleeding heavily, Advice: Cleanliness , daily bath, clean sanitary protection with frequent change. Cord care Advice on breast feeding (separate session will be held for training) , Eating healthy and balanced diet including fresh vegetables,Milk, cheese, butter, eggs fruit, meat, chicken and fish if possible , dry fruits ,and not just Halwas and desi ghee. Remember to inform that nothing is thanda or garm ; nothing will put hawa in the lady`s body. Check Vital signs : Pulse; Blood pressure , Temperature Pallor
Lochia Breast tenderness Feeding technique Uterus involution Leg pain EPISIOTOMY CARE
Sitz bath Warm water with salt vs Cold water Pros and cons :
Both help in healing but cold water with ice helps in pain relief. But may be impractical in extreme cold weather. Don’t`s:
Donot advice Dettol, Pyodine etc as they irritate the sensitive skin. Ice (Cold sitz bath) Immerse in room temperature water tub, for ten minutes , add few ice cubes it will provide pain relief Hot water with salt:
Warm water with added salt sitz bath three times a day for five to ten days.
• Ponston forte every eight hours • Brufen 400 mg twice daily • Anafortan twice daily
Add Ulsanic syrup if complains of heart burn Or Cap Nexum 40mg daily if there is severe heartburn. Advice Myacitracin , Bactroban, Healit, Poly fax ointment for local use thrice daily to prevent local infection. Cord care ; Apply spirit on cord three to four times daily.
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AGENTE BIOLÓGICO - Estrongiloidiasis NoMbre CieNtífiCo NoMbre verNáCulo, siNóNiMos Grupo de riesgo Características Los estrongiloides son nematodos (gusanos redondos) de entre 1,5 y 3 mm de longitud, finos y dioicos (con sexos separados). Las larvas rondan las 350 µm de longitud, los huevos, 40 µm. efectos sobre la salud Patógeno, a veces su parasitación es as