September 1, 2011

Post op plan for patient post Cesarean Section

For spinal analgesia
1) Keep patient lie flat till next review
2) V/S ½ hourly for 2H, then hourly till stable. After than 4 hourly.
3) Keep patient nil by mouth till next review
4) IV fluid maintenance 5 pints (2 pints D5%, 3 pints NS) / 24H
5) I/O chart
6) Pad chart
7) Keep CBD X 1/7
8) Wound inspection D2 (*some place, D3)
9) STO D7
10) S/C heparin 5000U B.D (6 hour post op till patient ambulate)
11) S/C Morphine 5 mg 4 hourly (*Some place may use suppositories voltaren)
12) IV antibiotic
- IV cefoperazone 1g BD
- IV metronidazole 500 mg t.d.s
13) Post op Hb (6 hour post op)
If patient under intra thecal analgesia
- Omit S/C morphine 5mg 4-Hrly
- Add IV piriton 10 mg t.d.s
- Add IV maxalon 10 mg t.d.s
If patient having blood loss more than 1000cc
- Withold S/C heparin until the result PT/aPTT come back and normal.
- FBC stat. To transfuse whole blood if Hb less than 8 or patient symptomatic.
- Double hematinic once patient tolerating orally

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