out slowly. As more of the head appears, check to be
sure that the umbilical cord is not wrapped around the
neck. If it is, either gently try to untangle the cord, or
move one section over the babys shoulder. If neither
of these actions is possible, clamp the cord in two
places, 2 inches apart, and cut it. Once the babys chin
emerges, support the head with one hand and use the
bulb syringe from the pack to suction the nostrils and
mouth. Before placing the bulb in the babys mouth or
nose, compress it; otherwise, a forceful aspiration into
the lungs will result. The baby will now start a natural
rotation to the left or right, away from the face-down
position. As this rotation occurs, keep the babys head
in a natural relationship with the back. The shoulders
appear next, usually one at a time.
NOTE: From this point on, it is essential to
remember that the baby is VERY slippery, and
great care must be taken so that you do not
drop it. The surface beneath the mother should
extend at least 2 feet out from her buttocks so
that the baby will not be hurt if it does slip out
of your hands. Keep one hand beneath the
babys head, and use the other hand to support
its emerging body.
Once the baby has been born, suction the nose and
mouth again if breathing has not started. Wipe the
babys face, nose, and mouth clean with sterile gauze.
Your reward will be the babys hearty cry.
Clamp the umbilical cord as the pulsations cease.
Use two clamps from the prepackaged sterile delivery
pack, 2 inches apart, with the first clamp 6 to 8 inches
from the navel. Cut the cord between the clamps. For
safety, use gauze tape to tie the cord 1 inch from the
clamp toward the navel. Secure the tie with a square
knot. Wrap the baby in a warm, sterile blanket, and log
its time of arrival.
The placenta (afterbirth) will deliver itself in 10 to
20 minutes. Massaging the mothers lower abdomen
can aid this delivery. Do not pull on the placenta. Log
the time of the placentas delivery, and wrap it up for
Place a small strip of tape ( ½ -inch wide), folded
and inscribed with the date, time of delivery, and
mothers name, around the babys wrist.
COMPLICATIONS IN CHILDBIRTH
Unfortunately, not all deliveries go smoothly. The
following sections cover various complications in
A breech delivery occurs when the babys legs and
buttocks emerge first. Follow the steps for a normal
delivery, and support the lower extremities with one
hand. If the head does not emerge within 3 minutes, try
to maintain an airway by gently pushing fingers into
the vagina. Push the vagina away from the babys face
and open its mouth with one finger. Get medical
If the cord precedes the baby, protect it with moist,
sterile wraps. If a physician cannot be reached quickly,
place the mother in an extreme shock position. Give
the mother oxygen, if available, and gently move your
gloved hand into the vagina to keep its walls and the
baby from compressing the cord.
If the mother experiences severe bleeding, treat
her for shock and give her oxygen, if available. Place
sanitary napkins over the vaginal entrance and rush her
to a hospital.
If a single limb presents itself first, immediately
get the mother to a hospital.
A medical emergency can occur at anytime. You
must be prepared to act expeditiously and confidently,
whether you are in a combat situation, on board a naval
vessel, or at the Navy Exchange. This chapter covers
the preliminary steps you should follow when
managing sick or injured patients. The preliminary
emergency steps include triage, patient assessment,
and, when needed, basic life support. Other related
topics covered in this chapter are breathing aids, shock,
diagnosis and emergency treatment procedures for
medical conditions and injuries, morphine use for pain
relief, and other common emergencies.
following chapters, diagnosis and emergency
treatment procedures for medical conditions and
injuries will be discussed.