Day 83 Dalaguete, Cebu DPC# Delivery Room, Intramuscular Injection, Intradermal Injection

I came back to Dalaguete today and worked in the ER. I did a couple skin tests and received a few patients for OPD checkups.

I also got to help with another delivery today. It was fairly quick and the nursing staff let me help prepare the infant right after delivery. After the baby had skin to skin contact with the mother and had started suckling (which is policy for the hospital here), the nursing staff cleaned off the baby and let me help with the measurements. We measured the circumference of the head, overall height, chest size, and weight. Afterwards, the nursing staff let me inject the infant with vitamin K. It's the first time I've ever injected a newborn and, in many ways, it was much easier than injecting adults. Firstly, the nurses loaded a syringe that we usually use for skin tests because the needle is much smaller and the infant doesn't need a huge dose.

There's a trick for loading such a small syringe (we used tuberculin syringes, which are 1cc). When drawing in whatever medication you're gonna use, the syringe has a tendency to fill with a bit of air (I've noticed this is especially true with TB syringes). That might not cause so much of a problem with 5cc syringes because you can always plunge out the excess air after loading some of the medication. With a 1cc chamber though, the amount of air is significant enough to throw off the measurement. Basically, in order to get an accurate measurement, you have to fill what you can and measure off starting from the bottom of the syringe. So let's say you want .3cc's of some medication. Instead of stopping and measuring from the .3cc line, you pull the plunger back and measure form somewhere near the middle or the back. So .3cc's might be loaded between  .6cc's and .3cc's (instead of 0-.3). Once you have that measured, you plunge out the excess air and you know that the .3cc's you have left are medication. The actual injection was simple because the needle was small enough that I could insert it all the way without hitting the bone (the injection site was the thigh).

Anyway, a pretty interesting day -- it'a always nice when I get to help with deliveries.