[CG] Neonatal Management During Covid-19 (Coronavirus) Labour Ward

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Labour Ward

Mother COVID 19 +ve or suspected: Low risk pathway No GA section, > 34 weeks GA Active resuscitation unlikely

Procedure for Neonatal Crash Call Attendance during Covid‐19 outbreak

Management of positive or suspected cases in neonatal unit

Management of neonates with possible contact but asymptomatic ( not for infants admitted from LW: see LW pathways)

Appendix 1: NEONATAL PPE QUICK GUIDE

Appendix 2: PPE Illustrated Guide

Donning and doffing videos on RHC Neonatal You Tube Channel:

Introduction

Donning: youtu.be/umfq‐aL3Uq4

Doffing

Labour ward and theatres? / NNU RHC videos


Appendix 3: Doffing PPE

Droplet Precautions

  • Doffing of PPE ‐ including decontamination of re usable eye protection in an isolation room
    The order of removing PPE is important to reduce cross contamination, so the order outlined below
    always applies even if not all items of PPE have been used.

  • Gloves – assume the outside of the glove is contaminated:
    Grasp the outside of the glove with the opposite gloved hand; peel off.
    Hold the removed glove in gloved hand.
    Slide fingers of the ungloved hand under the remaining glove at wrist.
    Peel second glove over first glove.
    Discard appropriately inside the room.
  • Gown or apron – assume the gown/apron front and sleeves are contaminated:
    Unfasten or break ties.
    Pull apron or gown away from the neck and shoulders touching the inside of the gown/apron only.
    Turn the apron/gown inside out.
    Fold or roll into a bundle and discard appropriately inside the room.
  • Second Gloves
    Remove as per first gloves and wash hands
  • Goggles or face shield – assume the outside of the goggles/face shield is contaminated:
    Don a pair of gloves and remove eye gear
    To remove, handle by the head band or ear pieces.
    Decontaminate eye protection using Alcohol/Clorox wipes.
    Remove gloves as per above
    Decontaminate hands using ABHR.
    Leave eye protection in the isolation room/donning area. Eye protection should be decontaminated
    using Alcohol/Clorox wipes before next use.
  • Surgical Mask – assume the front of the surgical mask is contaminated:
    Untie or break bottom ties, followed by top ties or elastic and remove by handling ties only.
    Discard appropriately inside the room.

Perform hand hygiene immediately after removing all PPE

Appendix 4: SOP bloods/samples for isolated infants SUSPECTED or POSITIVE COVID ‐19 In NICU

  • Stickers supplied in advance for sample container
  • Sample taken by operator in appropriate PPE*
  • Second operator dons standard PPE
  • Drop sample into clear plastic bag at door of isolation room
  • For blood gases
    • Run sample and dispose tube/ syringe in sharps box
    • After running sample wipe down analyser with Clinitex wipe or actichlor solution
  • Remove gloves, apron
  • Perform hand hygiene

Last reviewed: 07 April 2020

Next review: 23 September 2022

Author(s): Anne Marie Heuchan

Document Id: 932