question regarding cutting the umblical cord

[ghurty]

Hi,

I have a question regarding cutting the umblical cord

In my text book "brady 9edition" it says that you but the first clamp 10 inches from the mother and the second one about two inchines closer to the baby. But in the Mosby review book, it says that you pirt the first one 4 inches from the baby, and the next one about two inches closer to the mother.

What is the right way?

Thankx

[rcmedic]

I think that the second one is better. If you don't have 10 inches of umbilical cord out, you're really screwed if you go by the Brady book! ;-)

I learned it as "a little more than a hands width from the baby" and the second clamp goes "about 2 inches beyond that."

[EMS49393]

According to Brady's Paramedic Care textbook, you place the first clamp 10 cm (that's CENTIMETERS, not inches) from the baby, and the second clamp approximately 5 cm above the first. Allowing this much of the cord to remain attached to the baby allows for IV access in the event it's needed for resuscitation. Even though you might deliver what appears to be a completely healthy full-term baby, be aware that occasionally one will go bad on you when you least expect it. As a BLS provider, and even ALS providers in many areas, you'll never access the cord this way, however I know the ER's and NICU's will appreciate you a lot more if you leave them some cord to work with should they need it.

On a side note... Be careful how you read things. Most of medicine is on the metric system. There is a huge difference between 10 inches and 10 centimeters. My copy of the 10th edition EMT-B book is still in my car from teaching the other night. Frankly it's late and I'm too lazy to go get it and see how they word things, although you really have my curiosity peaked!

[RegularEMT]

According to Brady's Paramedic Care textbook, you place the first clamp 10 cm (that's CENTIMETERS, not inches) from the baby, and the second clamp approximately 5 cm above the first. Allowing this much of the cord to remain attached to the baby allows for IV access in the event it's needed for resuscitation. Even though you might deliver what appears to be a completely healthy full-term baby, be aware that occasionally one will go bad on you when you least expect it. As a BLS provider, and even ALS providers in many areas, you'll never access the cord this way, however I know the ER's and NICU's will appreciate you a lot more if you leave them some cord to work with should they need it.

On a side note... Be careful how you read things. Most of medicine is on the metric system. There is a huge difference between 10 inches and 10 centimeters. My copy of the 10th edition EMT-B book is still in my car from teaching the other night. Frankly it's late and I'm too lazy to go get it and see how they word things, although you really have my curiosity peaked!

This is what I was taught, and what my book says as well. I'd go with it, especially because NICU's prefer to have something to work with!

[AZCEP]

They told you this so that they had something to fill the space.

Clamp the cord in two places that are far enough apart so you can get the umbilical scissors or scalpel in between them. The distance from either end is really a matter of convenience. Too short, the clamp won't hold as well. Too long, you get the cord caught on things.

Preferrably, the cord should be cut sometime before the child reaches puberty, but you don't see this too often.

[Beagle189]

AZCEP has the best answer, On ALL points.

Just my opinion.

[ghurty]

Thankx for the responses.

So I went to check my book again, perhaps I did not read right. But here is a scan of the book!!

[rcmedic]

The AAOS book says this:

"6. Place the clamps about 2" to 4" apart, about four fingerwidths from the infant's body. Once they are firmly in place, cut between the clamps."

AAOS "Emergency Care and Transportation of the Sick and Injured" Eighth Edition, page 499.

That's where I got my information from. I wasn't just making it up. :-)

[TTLWHKR]

Cutting it...

Who in the hell came up with the idea of putting a scalpel in the OB kit. I've had a few with just surgical blades, nothing to hold it with. Wouldn't it be easier and more safe to throw in a pair of OB scissors?

I carry my own set, sterile and sealed, of course; I can just see some rook cutting the kid or himself with the scalpel.

[Ridryder 911]

Aww!!.. Be tough and naw & chew it apart ! Like they did hundreds of years ago...

R/r 911