CHAPTER XIII
MINOR OPERATIONS
Aseptic Care.—Place patient on a clean bed pan. It need not be sterile. Drape with a sheet and arrange it so the fold may be easily raised by nurse’s elbow. Have sterile basin with cotton pledgets to be filled with solution of lysol 1 per cent. Lysol must be put in basin first and the water added. Take to bedside. Nurse scrubs her hands ten minutes with a sterile brush, hot water, and green soap. Use no towel, no gloves. Keep hands wet and clean. Cleanse vulva with wet pledgets from above downward. Apply sterile pad.
Sterile Specimen.—To get a sterile specimen of urine without catheter, give aseptic care, tampon vagina with large pledget of sterile cotton. Have patient urinate in a sterile basin. Remove tampon.
Sterile Specimen from Child.—Take a glass test tube and thrust its round end through a hole in a square piece of adhesive plaster. Push it down until the plaster is caught and stopped by the enlarged rim at the mouth of the tube, with adhesive side of plaster on same side as opening of tube. Fasten the tube over the male penis or female vulva by applying the plaster to the surrounding skin. Leave until full.
Aseptic Douche.—Boil douche point and basin. Leave point in sterile basin. Fill douche can with sterile water, temperature 104° to 110° F. Put clean bedpan under patient who is draped with a sheet. Have at hand a sterile basin containing solution of lysol 0.5 per cent, or boric acid 5 per cent in which cotton pledgets are immersed. Scrub the hands as for aseptic care. Cleanse the vulva with cotton pledgets, washing always toward the anus, and use each pledget but once. Adjust the douche point and introduce it just inside the labia. The douche can should be only a trifle higher than the pelvis. When can is empty, apply a sterile pad.
Fig. 86.—Apparatus for getting a sterile specimen of urine from an infant.
If the douche is to be used as a deodorant after the fifth day of the puerperium, either of the following solutions may be employed: Potassium permanganate, 1:5000; formaldehyde 1 dram to quart, or chinosol 1:1000.
The vaginal douche may be used in cases of gonorrhœal infection in pregnancy during the last weeks, in the hope of avoiding infection of the child’s eyes.
It is given like the aseptic douche (q. v.) with potassium permanganate 1:5000, or chinosol 1:1000. It should be hot (112° to 120° F.), and be begun not long before term, so that in case labor comes on, the danger to the child will be minimized. The reservoir must not be too high, nor the douche point inserted much beyond the labia. The woman should be on her back and the douche point should be rubber or glass.