Maternity Arrangements For The Provision Of Assistance

Original Language Title: Dzemdību palīdzības nodrošināšanas kārtība

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Cabinet of Ministers Regulations No. 611 in Riga in 2006 (25 July. No 39 22) maternity assistance assurance order Issued in accordance with the sexual and reproductive health Act 9. the third paragraph of article i. General questions 1. determines the procedure for the provision of assistance during childbirth.
2. is responsible for the compliance with the provisions of the medical institutions.
3. Treatments the person providing maternity assistance, complete medical records in accordance with the laws and regulations on medical institutions, medical and accounting documentation record keeping procedures.
II. provision of assistance during childbirth Pregnancy Childbirth assistance 4 gestation period in accordance with Annex 1 of these rules provide one of the following treatments for individuals: 4.1 gynecologist (birth);
4.2. the family doctor or midwife if pregnancy occurs physiologically.
5. Gynecologist (birth), midwife or family doctor evaluate the maternity risk and determine which of the provisions referred to in paragraph 4, the treatment of persons will take care of the pregnant women below: 5.1 first visit;
5.2. any other pregnancy, if have appeared or are deliberately what pregnancy risk factors.
III. Maternity provision of assistance giving birth 6. Childbirth assistance at birth according to the individual by CAI medical indications according to competency provided by one of the following treatments for individuals: 6.1. hospital medical institution which meets the requirements laid down in the laws and institutions and their treatment units: gynecologist 6.1.1 (birth);
6.1.2. the midwife;
6.1.3. the anaesthetist, visit his acquaintance Peteris Klava;
6.1.4. do not onatolog or paediatrician;
period of ārpusstacionār giving birth-medical institution working gynecologist (birth) or midwife who has got medicinal and diagnostic methods of planned giving birth ārpusstacionār certificates help.
7. The provisions referred to in paragraph 6 of the treatment the person provides a complete and understandable information about giving birth and possible complications.
8. If a pregnant woman choose planned ārpusstacionār of birth: 8.1 the medical establishment, the person providing the medical assistance in childbirth giving birth of planned ārpusstacionār, shall be the subject of a written contract with a pregnant woman. The contract declares that a pregnant woman has received a full and comprehensible information on the required labor environment, the nature of birth, possible difficulties in mother and child at birth and postpartum period, risk factors, the expected behavior, as well as the conditions of payment for the service;
8.2. treatment the person providing maternity assistance outside the planned hospital birth, comply with the following conditions: 8.2.1. ensure minimum equipment planned for the conduct of the ārpusstacionār birth according to annex 2 of these regulations;
8.2.2. the indications found mothers for carriage on a stationary treatment in accordance with annex 3 of these regulations, provide the transport 30minūš mothers and mothers to accompany a stationary treatment that may get maternity help.
IV. Maternity help who help Birth 9 not dēļniec (42kalendār days after delivery) according to the rules referred to in annex 1, as well as the individual medic niskaj indications provided in one of the following treatments for individuals: 9.1. gynecologist (birth);
9.2. the midwife.
10. the Birth of a newborn who help (27kalendār days after delivery) according to the rules referred to in annex 1, as well as individual medical indications provided by one of the following treatments for individuals: 10.1. gynecologist (birth);
10.2. the midwife;
10.3. no onatolog;
10.4. the paediatrician;
10.5. the family doctor;
10.6. the nurse or physician's Assistant, working in the family doctor's practice.
11. The medical establishment, the person providing the medical assistance in childbirth giving birth, organized by onatolog or not included in the overview the newborn first SafeSeaNet isoperational after birth.
12. These rules 9 and 10 in the treatment referred to in paragraph a person, finding the indications do not dēļniec or transfer to hospital of a new treatment in accordance with annex 3 of these rules, call the emergency medical team, and provides assistance to its arrival.
Prime Minister-economic Minister a. Štokenberg Health Minister g. Smith Editorial Note: the entry into force of the provisions by 28 July 2006.
1. the annex to Cabinet of Ministers of 25 July 2006, regulations no 611 assistance during pregnancy and Childbirth who abbreviations used in the table: 1.US-ultrasonogrāfisk investigation.
2. Rh-rhesus factor.
3.-Australia Antigen HbsAg.
4. SED-rapid response with the inactivated serum.
5. the TPH-demonstration of Treponema pallidum haemagglutination reaction passive.
6. IF the anti-HIV ½-imūnfermentatīv analysis.
7. APP-A-with pregnancy associated plasma protein.
8.? HG-beta horiongonodotropīn.
9.AT-arterial blood pressure.
10.? FP-Alpha feta protein.
11.-radiography X ray.
12. Hb-haemoglobin.
13. OGT, oral glucose tolerance test.
14. the VHB – viral hepatitis b. 15. vaccine against tuberculosis-BCG.
Health Minister g. Smith annex 2 Cabinet of 25 July 2006, regulations no 611 Mandatory equipment planned for delivery in 1. ārpusstacionār medical devices: 1.1 sphygmomanometers;
1.2. fonendoskop;
1.3. the stethoscope;
1.4. the medical thermometer;
1.5. measuring tape;
1.6. the weight of the newborn weighing;
1.7. manual vakuumekstraktor;
1.8. sterile instruments: scissors, five terminals (straight, curved and vascular), umbilical cord, an episiotomy scissors shears, needle holder, tweezers (anatomical and surgical), kornstang, Simps mirrors (upper and lower);
1.9. the rubber suction of secretions can newborn upper respiratory; foot-operated suction device;
1.11 neonatal and adult size portable artificial lung ventilation (breathing bag with oxygen tanks, appropriate size face mask and oxygen flow input options);
1.12. newborn and adult sizes orofaringeāl, nazofaringeāl the airway;
1.13. the portable oxygen tank with gas capacity of at least 400l, equipped with a flow meter and Regulation valve, which ensures maximum flow at least 15 l/min;
1.14. newborn and adult size laringoskop with mirrors;
1.15. newborn and adult size of Endotracheal tubes and leadwire;
1.16. Magill Terminal;
1.17. nierveid Bowl.
2. Materials: 2.1 the newborn and adult size of catheter to suction secretions from the airway;
2.2. the umbilical cord/cord clips;
2.3. the five syringes with needles (20ml);
2.4. the five syringes with needles (10 ml);
2.5. the five syringes with needles (1);
2.6. the sewing material with needles;
2.7. sterile gauze swabs, tiles, cotton wool;
2.8. the two umbilical vein catheter in newborn;
2.9. the two adult intravenous catheters;
2.10. vein catheter locking material;
2.11. intubation tube clamping materials; short infusion systems;
2.13. two bladder catheter;
2.14. the contact gel;
2.15. vakutainer blood samples of umbilical cord blood vessels;
2.16. four outs, two sterile towels;
2.17. four pairs of sterile and non-sterile four pairs of gloves;
2.18. working clothes.
3. in the event a boxed-in minimum medication to ensure medical treatment: 3.1 womb astringent features (uterotoniķ): 3.1.1. oxytocin-15 IU;
3.2. heart-lung function necessary for the maintenance of medication: mg atropine sulphate-injection, solution;
3.2.2. epinephrine hydrochloride, solution for injection, 10 mg;
3.2.3. dopamine hydrochloride 200 mg, solution infusion –;
3.2.4. lidocaine hydrochloride 240 mg, solution-i/v injection;
3.2.5. magnesium sulphate, solution for injection, 5 g;
3.3. the analgesic medication tramadol hydrochloride: 3.3.1-200 mg, solution for injections;
3.3.2. metamizole-2 g, solution for injections;
3.4. blood pressure lowering medication required: 3.4.1. clonidine dosage-0.15 mg hydrochloride tablets under the tongue for use;
3.4.2. nifedipīn – 10 mg, tablets for use under the tongue;
3.5. the antiangināl medication: 3.5.1-nitrosorbīd 10 mg tablets;
3.5.2. metoprolol 50 mg-tablets;
3.6. the bronholītisk medication: 3.6.1. aminophylline-480mg, solution for injections;
3.7. drugs with effects on the central nervous system: 3.7.1-20mg, diazepam solution injection;
3.8. the diuretic medication: 3.8.1. furosemide-100 mg, solution injection;
3.9. the adrenal hormone substitute medication: 3.9.1. hydrocortisone sodium succinate-500 mg, freeze-dried powder;
3.9.2. – 180 mg prednisone solution injection;
3.10. blood substitutes: 3.10.1. sodium chloride 0.9% solution, 500 ml, infusion;
3.10.2. Ringer's solution or Ringers lactate-1000ml, solution infusion;
3.10.3. glucose-100 ml, 10% solution infusion;
3.11. antidotes: 3.11.1.-0.8 mg, naloxone injection solution;
3.12. the local anesthetics: lidocaine 10% 3.12.1-spray;
3.13. other medication: 3.13.1 hloropiramīn hydrochloride-40 mg, solution for injections;
3.13.2. Vitamin K – 4 mg;

3.13.3 sodium hidrogenkarbonāt (NaHCO3) 4.2% to 250ml.
4. Disinfectants: 4.1. skin disinfection;
4.2. mucous membrane disinfection;
4.3 disinfection of instruments;
4.4. surface disinfection.
Health Minister g. Smith annex 3 Cabinet of 25 July 2006, regulations no 611 indicating not all mothers and newborn dēļniec transfer to stationary treatment 1. indicating mothers for carriage on a stationary treatment: birth complications: 1.1 1.1.1. premature rupture of the shell of the fruit;
1.1.2. bleeding from childbirth;
1.1.3. horioamnionīt;
1.1.4. kardiotokogrāfisk investigation or with auscultation of fetal heart rate abnormalities detected;
1.1.5. the green waters of the fruit;
1.1.6. the umbilical cord or priekšguļ loss;
1.1.7. intrauterine fetal death;
1.1.8. primary or secondary uterine dysfunction;
1.1.9. partial or absolute fruit heads and the mother's pelvic incompatibility;
1.1.10. ominous or uterine rupture;
1.1.11. put down the fruit or priekšguļoš parts of Pathology;
1.1.12. placenta detachment or withdrawal disorder;
1.1.13. maternity road injury rate (except for I-IIpakāp-perineal or cervical fracture);
1.1.14. inadequate participation by mothers;
1.2. election of mothers;
1.3. other reasons that cause health or life.
2. The indications do not transfer to hospital of a dēļniec treatment: bleeding from childbirth 2.1;
2.2. election of dēļniec;
2.3. other reasons that cause health or life.
3. indicating the transfer to the new stationary treatment: 3.1 asphyxia;
3.2. respiratory insufficiency: two hours after the birth of accelerated breathing (more on 60reiz for a minute), palīgmuskulatūr participation in breathing, grunting;
3.3. General cianoz or akrocianoz later than six hours after birth;
3.4. the appearance of jaundice in the first 24 hours after birth, skin pallor (especially if possible rhesus factor or blood group incompatibility);
3.5. purulent skin or mucous membrane disease, rash (Petechial or exception toxic Erythema of the newborn items);
3.6 abnormal central nervous system simptomātik (neonatal depression or agitation, convulsions, paralysis or parēz);
3.7. gastro-intestinal tract disorders (vomiting, diarrhea, ingestion problems); īmredzam innate development abnormalities or suspicious of them;
3.9. newborn condition that requires immediate assistance (bleeding, heart malfunctions, breathing stops);
3.10. no clear pathological neonatal status;
3.11. the election of the dēļniec;
3.12. other reasons.
Health Minister g. Smith