Preparations for Confinement

enema, towel, squares, nurse, solution, carbolic and cut

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These things—waterproofs, sheets, &c.— should be obtained in time, before the confine ment. They should be removed from the paper in which they are usually wrapped and each rolled up separately in a thick towel, the sides of the towel folded in on them and the end pinned off, and they should be placed away in a drawer reserved to themselves. If shoved away anywhere, in the paper in which they are received, the paper will certainly become torn and they will get dusty and stained.

Gamgee, a specially prepared absorbent wool, made in thick sheets held by gauze on each side, is an excellent substirde for accouche ment sheets, sanitary towels, &c. It is obtained in 1-pound rolls. A piece of this of full breadth and of requisite length should be cut for laying on the upper waterproof, other pieces suitable as to length and breadth for napkins for the mother should also be cut, and another lot of pieces cut in 3-inch squares should be prepared for sponges. The nurse should cut these before hand . two or three pieces for sheets, a dozen or so for diapers, two or three dozen squares, and should be kept each lot rolled up securely in its own towel. In another towel should be rolled up 1 sheet; 2 or 3 diapers, and 4 or 6 squares, so that the nurse needs only to undo one towel to get what she needs on any one occasion, and does not need to expose her whole stock every time she wants a diaper or a square.

Sponges must never be seen inside the lying in room. They are, as a rule, nests of foulness. The squares of gamgee, noted in the last para graph, are available for all purposes. Specially must the mother's genital organs never be touched by a sponge, either just before, during, or in the days immediately succeeding labour.

The squares of gamgee are available for every purpose, wet to sponge with, and dry to dry with.

Utensils for the Room.--Besides the articles already named, there should be at hand a drinking-cup, a measure-glass, a bed pan of the slipper form (Plate XXXVII.), a china or enamelled slop-pail, a rubber 0i:other hot.water bottle. The cleanliness of these the nurse should herself directly see to. They should never be allowed to lie soiled. At the earliest moment slops should be carried from the sick-room. Under no circumstances should they be pushed under the bed, out of sight, lest they be forgotten. At the earliest moment they

should be carried from the room, the vessels immediately washed, and, in the case of the bed-pan and slop-pail, rinsed out with some disinfectant, such as chloride of lime solution. The wash-hand basin should be cleansed with a brush and antiseptic solution, such as per manganate of potash, Lysol, or carbolic. They should then be dried and brought back perfectly clean and ready for use.

Instruments needed by the nurse requires the following While the nurse should have these instruments herself, it is much better that the patient should have her own enema rather than that one should be used for her which may have been employed for many other persons. The enema should, but for the nozzle and vaginal piece, be of pure white rubber. It will then stand boil ing, and will thus be made quite free of possible infection, be, that is, aseptic. To boil it, a per fectly clean pot is used, pure cold water is put in, with a teaspoonful bicarbonate of soda to each pint of water. The enema is completely immersed, squeezed several times to fill it com pletely, the lid is put on, and the whole boiled for 2 or 3 minutes. It is then removed, and immersed before use in, and completely filled with, a solution of carbolic acid (1 to 20) or Lysol (a tea-spoonful to a pint). If the enema is to be put away, ready for use, it should be lifted out of the pot, emptied of water, and wrapped up in a perfectly clean towel.

If any of the parts of the syringe are made of vulcanite they are apt to be injured by boil ing. In such a case immersion in 1-20 carbolic should be employed, the syringe being filled with the solution.

The Catheter can be boiled so quickly that it should be so treated just before use, and then immersed in the carbolic solution, out of which it should be lifted and used wet.

The Clinical Thermometer is described on P. A douche may be given with the enema syringe, but a special apparatus is best (see Plate XXXII). It should be made aseptic iu the same way as the enema. The half-ring of vul canite to rest on the edge of the vessel contain ing the douching fluid will not stand boiling.

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