vkn'kz izlo d{k fn'kk&funsz'k NRrhlx<+

vkn'kz izlo d{k fn'kk&funsz'k NRrhlx<+ DRAFT 2016 DIRECTORATE HEALTH SERVICES & NATIONAL HEALTH MISSION NEW RAIPUR, CHHATTISGARH

vkn'kz izlo d{k fn'kk&funsz'k vkn'kz izlo d{k dk gksuk ekr`&f'k'kq LokLF; dh xq.korrkiw.kz lsok ds fy, vko';d gsa vkn'kz izlo d{k ds fdz;kuo;u gsrq fueufyf[kr fn'kk&funsz'k gs%& 1) izlo d{k esa nh tkus okyh vfuok;z lsok;sa xhkzorh efgyk dsk izlo d{k esa izlo ds lfdz; pj.k (Active Phase) esa ys tkuk pkfg, tsls%&fxzok (Cervical Dilation) dk QSyko 4 ;k 4 lseh- ls vf/kd gks Partograph ds ek/;e ls fuxjkuh f'k'kq dk tue izlo ds rhljs pj.k dk lfdz; izca/ku uotkr f'k'kq ds ns[khkky ds lkfk uotkr f'k'kq dk Resuscitation Lruiku dh 'kq:vkra Episiotomy/Tear repair tfvyrkvksa dh igpku,oa izca/ku ;fn efgyk rs;kj gks rks PPIUCD dk Insertion 2) v/kkslajpuk (Infrastructure) izlo d{k izlo d{k ls tqm+k gqvk fdz;k'khy 'kkspky; (Functional Toilet) uotkr f'k'kq ns[khkky bzdkbz ds fy, LFkku (NBCC Corner) uflzax LVs'ku ds fy, LFkku/Service Area fqzt (Refrigerator) ds fy, LFkku 3) izlo d{k ds fy, midj.k,oa lkexzh%& izr;sd izlo d{k esa fueu midj.k,oa lkexzh vfuok;z :i ls gksuk pkfg,a izlo Vscy (Labour Table) xn~ns ds lkfk] pknj] rkfd;k(case load ds vk/kkj ij la[;k½ Macintosh, Foot Step, Foot Rest. jdr,oa Amniotic rjy inkfkz,d= djus ds fy, Kell`ys Pad & Bucket lsdam dkavs okyk fnoky?km+h (Wall Clock) FkekZehVj nhoky esa Vaxk gqvka Suction Apparatus Adult Resuscitation midj.k izr;sd izlo Vscy ds fy, delivery trolly IV drip stand 1 P a g e I d e a l L a b o u r R o o m G u i d e l i n e, C h h a t t i s g a r h

nks izlo Vscy ds chp insza tue lg;ksxh ds fy, dqlhz@lvwy nhoky ls yxk gqvk ysei nlrkus (Gloves), Cotton ¼dkWVu½] xkwt (Gouge), lsusvjh ism (Sanitary pad),izu] Thread, catgut, IV drip set, needle ¼lqbZ½, Cord clamp, nokbz;kw (Injectable, oral and parental, Leucoplast etc.) izr;sd izlo gsrq Autoclaved delivery set fqzt flqxeksesuksehvj (B.P.. Instrument), o;ld,oa uotkr FkekZehVj] otu e'khu Pulse Oxymeter ¼iYl~ vkwdlhehvj½ LVjykbZtj vkwdlhtu flysumj ikvkszxzkq nokbz;kw,oa butsd'ku j[kus ds fy, Plastic Jars gksus pkfg, ftlesa nokbz;ksa ds uke,oa volku frffk (Expiry date) fy[ks gksus pkfg,a tso fpfdrldh; vif'k"v izca?ku ds fy, Colour Coded Bins Hub Cutter (Needle Cutter) ¼gc dvj½ iapj jfgr MCcs (Puncture proof container) 0.5% Dyksfju?kksy ds fy, Plastic Bottle Intranatal izksvksdkwy] Posters for display (AMTSL,PPH vkfn gsrq½ Oghy ps;j@ejht VªkWyh@LVªspj fmyhojh Vªs] Episiotomy Vªs] MVA Vsª] PPIUCD Vªs] Baby Vªs] Medicine Vªs] Emergency Drug Vªs] gkfk /kksus dk {ks=,oa HkrhZ ejht gsrq 'kkspky; Foetoscope/Foetal MkIyj LVsFksLdksi SBA xq.korrk izksvksdkwy dk izn'kzu Shadow less lamp epnj Hkxkus dk lk/kua 2 P a g e I d e a l L a b o u r R o o m G u i d e l i n e, C h h a t t i s g a r h

4) izlo d{k gsrq lkr Vªs%& dz- Vªs dk uke midj.k@nok@lkexzh 1 fmfyojh Vªs Scissor Artery Forceps Sponge holding Forceps Speculum Urinary Catheter Bowl for antiseptic lotion kidney tray Gauge Piece Cotton Swabs Sanitary Pads Gloves 2 bihfl;ksvkseh Vªs Gloves 3 P a g e I d e a l L a b o u r R o o m G u i d e l i n e, C h h a t t i s g a r h Inj. Xylocaine 2% 10 ml Disposable syringe with needle Episiotomy scissor Artery forceps Allis forceps Sponge holding forceps Toothed forceps Thumb forceps Kidney tray Needle holder Needle ( Round Body & Cutting ) Chromic Catgut no.0 Gauge pieces Cotton swabs Antiseptic lotions

3 csch Vªs Two pre-warmed towels/ Sheets for wrapping the baby Mucus extractor Bag & mask Sterlized thread/ cord clamp Needle ( 26 guage) & syringe (1 ml) Inj Vitamin K Gloves ¼f'k'kq dks igys ls xez rksfy;s esa fy;k tkuk pkfg,a blds fy, /kkrq dh Vªs dk mi;ksx u djsa½ 4 nokbz;ksa dk Vªs Inj. Oxytocin Inj.Gentamicin Inj. Vit K Inj. Betamethasone Inj. Hydralazine Cap. Ampicillin 500gm Tab. Metronidazole 400mg Tab. Paracetamol Tab. Ibuprofen Tab. B complex Tab. Misoprostol 200micrograms * usfojsfiu vksj vu;,pvkbzoh nokbz;kw dsoy,dhd`r lykg vksj tkwp dsunz ¼vkbZlhVhlh½ vksj,avh jsvªksfo;y Fksjsih ¼,vkjVh½ dsunzksa ds fy, gh gsaa 4 P a g e I d e a l L a b o u r R o o m G u i d e l i n e, C h h a t t i s g a r h

5 vkikrdkyhu nok Vªs **Inj. Oxytocin (should be kept in regerigerator ) Inj. Magsulf 50% Inj Calcium gluconate 10% Inj. Dexamethasone Inj. Ampicillin Inj. Gentamicin Inj. Metronidazole Inj. Lignocaine 2% Inj. Adrenaline Inj. Hydrocortisone Succinate Inj. Diazepam Inj. Pheneramine Maleate Inj. Corboprost Inj. Pentazocin Chloride Inj. Promethazine Inj. Betamethasone Inj. Hydralazine IV fluids- Ringerlactate, Normal Saline IV sets with 16 gauge needle at least 2 IV Cannula Vials for blood collection Syringes & needles Tab. Nifedipine Tab. Methyldopa Suction Catheter Mouth gag ¼** dsoy Lrj 2 vksj lsok dsunzksa ds fy,½ 6 esu;qvy osd;we,lihjs'ku ¼,eoh,½@bysDV«hd Speculum osd;we,lihjs'ku ¼bZo,½ Vªs 5 P a g e I d e a l L a b o u r R o o m G u i d e l i n e, C h h a t t i s g a r h

Anterior vaginal wall retractor Posterior vaginal wall reactor Sponge holding forceps MVA syringe & cannulas MTP cannulas Urinary catheter Small bowl of antiseptic lotion Sterlized gauge /pads Cotton swabs Disposable syringe & needle Tab. Misoprostol 7 isklv ikvze bavªk ;wvsjkbu damªklsfivo fmokbl ¼ihihvkbZ;wlhMh½ Vªs *** PPIUCD Insertion Forceps Sim's Speculum Ring forceps / Sponge holding forceps Cu IUCD 380A/ Cu IUCD 375 in a sterile package Cotton swabs Betadine Solution (*** dsoy LokLF; dsunzksa ds fy, tgkw izf'kf{kr ihihvkbz;wlhmh iznkrk gks½ 6 P a g e I d e a l L a b o u r R o o m G u i d e l i n e, C h h a t t i s g a r h

5) Service Area ¼dk;Z {ks=½ izr;sd izlo d{k esa Recording/Reporting,oa isij dk;z gsrq fu/kkzfjr {ks= gksuk vfuok;z gs,oa ;g ejht {ks= ls,dne vyx ugha gksuk pkfg, blls M~;qVh esa dk;zjr dezpkjh@lvkq dksbz Hkh vkikrdkyhu flfkfr esa ;k izlo d{k esa xhkzorh efgyk dks ;fn fdlh Hkh t:jr ij rqjar izfrfdz;k dj ldsxha bl {ks= dks nokbz;ksa] midj.k] Consumables vkfn j[kus gsrq mi;ksx esa ugha ykuk pkfg,a nokbz] midj.k] Consumables dks replacement stock ds :i esa izlo d{k ds ckgj j[kuk pkfg,a jdr L=ko ls cpko,oa mipkj ds fy, Oxytocin nok igyh izkfkfedrk gsa ;g Low resource setting tsls miloklf; dsunzksa esa Oxytocin dk mi;ksx ugha fd;k tk ldrk D;ksafd bls Refrigerator ¼fQzt½ esa j[kk tkrk gsa;fn Oxytocin injection miyc/k ugha gs rks Oral Mesoprostol (600 Mcg) dh xksyh dk mi;ksx dj ldrs gsa izlo d{k ds lqy fdz;kuo;u gsrq,d izlo Vscy ds fy, 10x10 sq.ft. dh txg,oa 2 izlo Vscy ds fy, 20x20 sq.ft. dh txg gksuk pkfg,a izr;sd izlo Vscy esa Sleek vertical trolley gks ftlesa 7 Vªs j[kus ds fy, txg gks ¼mijksDrkuqlkj½ 6) Newborn Care Corner ¼uotkr f'k'kq lqj{kk bzdkbz½ izr;sd izlo d{k esa uotkr f'k'kq lqj{kk bzdkbz (NBCC) vfuok;z :i ls gksuk pkfg,a izr;sd izlo d{k,oa izlqfr vkijs'ku ffk;svj esa NBCC dkuzj gks ftlesa,d jsfm;suv okezj],d Functional ambu bag,oa mfpr Size dk Mask gksuk pkfg,a 7) tue ds le; vfuok;z lsok ¼lqj{kk½ uotkr dk Resuscitation xehz gsrq izko/kku Lruiku dh tyn ls tyn 'kq:vkr uotkr dk otu ysuk tuetkr fodykaxr ds fy, uotkr dk fujh{k.k uksv%& lhkh uotkr dks Radiant warmer esa j[kuk vfuok;z ugha gsa ekrk,oa f'k'kq esa fueufyf[kr y{k.k fn[kus ij Radiant Warmer esa f'k'kq dks vkikrdkyhu uotkr ns[khkky ds fy, j[kuk pkfg,,oa vko';drkuqlkj Resuscitation nsuk pkfg,a fedksfu;e Stained Liquor,oa le; ls iwoz izlo gksus ij uotkr ds ugha jksus ij] isjksa esa viaxrk] gkfk isj detksj] vaxks ds fu"dzh; fn[kus ij,oa fpfdrld ds lykg vuqlkj 7 P a g e I d e a l L a b o u r R o o m G u i d e l i n e, C h h a t t i s g a r h

8) uotkr lqj{kk bzdkbz ds fy, vko';d midj.k,oa lkexzh csch Vªs fifm;kvªhd LVsFksLdksi ¼uotkr LVsFksLdksi csgrj fodyi gs½ csch Ldsy jsfm;suv okezj Pediatric ambu bag & mask-neonatal, Size (0 and1) Oxygen hood ¼Neonatal) Laryngoscope and Endotracheal Intubation tube nks tksm+s isfuly csvjh ¼lsy½ Mucous extractor suction tube ds lkfk,oa isjksa ls vkwijsv djus okyh suction e'khu NG tube (uslksxslvªhd V~;wc½ Blankets ¼dEcy½ nks lkq,oa lw[kk Vkosy Feeding tubes jdr,df=r djus ds fy, 2 [kkyh Vials Alcohol hand rub HLD/Sterile gloves Disposable lhfjt] Hub Cutter. Injection Vit.K 1mg 9) izlo d{k ds fy, lkeku; vko';drk,w izlo d{k dh lrg (Floor) esa fcuk design okyh] fqlyu fujks/kh lqsn Tile yxkuka lrg ls 6 fqv rd fnoky esa VkbYl yxs gksuk pkfg, 'ks"k fnoky,oa Nr esa lqsn isav yxkuk pkfg,a foumks,oa Ventiltors, Froasted Glass ds lkfk gksuk pkfg,a f[km+fd;ksa esa ed[kh] epnj,oa dhm+ks dks jksdus ds fy, tkyh gksuk pkfg,a izlo d{k,oa izlo d{k ls tqm+s gq, 'kkspky; esa 24?kaVs ikuh dh lqfo/kk gksuk pkfg,a ;fn ikuh dh vkiwfrz lhfer gs rks vksojgsm VSad gksuk pkfg,,oa ikuh iai ds ek/;e ls vksojgsm VSad esa ys tkus dh O;oLFkk dh tkuh pkfg, okf'kax {ks= esa Elbow Operated Tap yxk gksuk pkfg,a izr;sd izlo d{k esa,d fqzt gksuk pkfg, ftlesa injection oxytocin j[kk tk ldsa izlo d{k dk {ks=@vkdkj o folrkkj dh la[;k izlo Vscy dh la[;k dsunz esa izlo gsrq HkrhZ efgykvksa dh la[;k ds vk/kkj ij gksuk pkfg,a izlo d{k esa izdk'k gsrq Emergency Light/Inverter/Ganerater/Power Backup gksuk pkfg,a 8 P a g e I d e a l L a b o u r R o o m G u i d e l i n e, C h h a t t i s g a r h

10) vfuok;z nokbz;ksa lkirkfgd,oa ekfld LVWkd gsrq esvjfuvh foax esa vyx ls Store gksuk pkfg,a r`rh; Lrj (Level-3) ds izlo d{k esa Centrally air conditioned ds lkfk air handling unit gksuk pkfg,a ;fn air condition miyc/k ugha gks rks Cross Ventilation ds lkfk exhaust vko';d gsa ;fn izlo d{k esa Air condition gs rks ;g /;ku j[kk tk, fd NBCC esa lh/ks uotkr f'k'kq ds mij BaMh gok ugha tkuk pkfg,a 11) izlo d{k esa ladze.k jksdfkke vlirky ds dezpkfj;ksa,oa izlwrk ds fj'rsnkjksa ds fy;s izlo d{k esa tkus gsrq vyx ls piiy dh o;olfkk gksuh pkfg,a izlo gsrq tkus okyh ejht dks Sterile gown nsuk@igukuk pkfg,a izlo d{k dh lrg dks ¼Hkkjr ljdkj }kjk tkjh izksvksdkwy ds vuqlkj gksuk pkfg,a izlo djokus ds fy, mi;ksx fd;s tkus okys nklrkus] midj.kksa] Linen vkfn dk Sterilization vpns ls gksuk@djuk pkfg,a disinfection and sterilization ds fy, ekud izfdz;k viuk;h tkuh pkfg,a mi;ksx djus ds i'pkr~ lkexzh dks Floor ;k vu; txg ij ugha Qasduk pkfg,a lkexzh dks Cyhfpax ikmmj ds?kksy esa Mqckuk pkfg,,oa lqkbz,oa Autoclaving ds fy, Hkstuk pkfg,a Decontamination dh izfdz;k i'pkr~ mi;ksx esa dh xbz lkexzh dks Sterlization ds fy, Hkstuk pkfg,a lkcqu ds ikuh ls lrg dks lkq djuh pkfg,,oa lrg dks lw[kk j[kuk pkfg,a izlo Vscy ds mijh lrg dks fqukwy@cyhphax?kksy ls lkq djuk pkfg,a vkyekjh] Shadow less lamp, lockers, trolley vkfn ds lrgksa dks low level okys Disinfectant ls lkq djuk pkfg,a bysdvªkwfud ewkfuvj dks 70%,Ydksgy ls lkq djuk pkfg,a Floor esa ;fn [kwu ds NhaVs] 'kjhj ds rjy inkfkz fxjus ij Cyhphax?kksy mlds mij Mkys,oa 10 feuv rd NksM+ nsa fqj iksank yxkuk pkfg,a Placenta ¼Iysls avk½ dks ihys jax ds MCcs esa Mkyuk pkfg,a mi;ksx fd;s x;s linen dks Cyhphax?kksy esa Disinfect djus ds i'pkr~ lqkbz,oa Autoclaving ds fy, HkstukA izlo d{k ds lrg dks izr;sd 3?kaVs esa Disinfectant?kksy ls iksank djuk pkfg,a izr;sd izlo i'pkr~ yscj@izlo Vscy dh lqkbz djuk pkfg,a 12) vkn'kz izlo d{k gsrq ekuo lalk/ku dk izf'k{k.k (Training),,u,e@LVkQ ulz dks Ldhy cfkz vvsamsav@uotkr f'k'kq lqj{kk dk;zdze@imnci esa izf'k{khr gksuk pkfg,a xzkeh.k fpfdrlk lgk;d dks Ldhy cfkz vvsamsav@bemonc esa izf'k{khr gksuk pkfg,a 9 P a g e I d e a l L a b o u r R o o m G u i d e l i n e, C h h a t t i s g a r h

fpfdrlk vf/kdkfj;ksa dks BEmONC/CEmONC esa izf'k{khr gksuk pkfg,a LVkQ ulz@fpfdrlk vf/kdkfj;ksa dks lqj{khsr xhkzikr lsokvksa@mtp esa izf'k{khr gksuk pkfg,a 13½ tue lg;ksxh dk;zdze (Birth Companion programme) ijaijkxr :i esa ekrk çlo ds {k.kksa esa vius ifjtuksa ds lkfuu/; esa gksrh FkhA bl çdkj viuksa dk lkfk gksuk çlo dh vr;f/kd ihm+k,oa ruko dks de djrk gsa,sls le; esa viuksa ds }kjk nh xbz lkarouk] lgt&hkko lefkzu,oa lkfk cgqr vge gksrk gsa xhkzorh efgykvksa dks çlo ds nksjku fujarj vk'oklu] vkjke] çksrlkgu vksj leeku dh vko';drk gksrh gsa ;g lhkh çlo ds nksjku fdlh vius ds lkfk gksus ls lgtrk ls gksrk gsa vr% çlo ds nksjku efgyk ifjtu dk miflfkr jguk,d egroiw.kz igy gsa blh /kkj.kk ds lkfk tue lg;ksxh dk;zøe çkjahk fd;k tk jgk gsa mn~ns';%& çlodky esa xhkzorh ekrk ds ifjokj ds Hkkxhnkjh dk volj nsuka çloiwoz] çlo] çloksùkj vof/k ds nksjku csgrj ekufld LokLF; cuk;s j[kuka 1) tue lg;ksxh%& ;g dk;zdze rfeyukmw,oa fons'kksa esa lqy jgk gsa bl dk;zdze ls fueu ykhk gksaxs%& çlo dh le;kof/k esa deh çlo ihm+k esa deh HkkoukRed ruko esa deh çlo ls nokbz;k,oa çfø;k dh vko';drkvksa esa deh xahkhj çlo ds çek.k esa deh çlo i'pkr~ dh lel;kvksa esa deh ifjtu lqfo/kk lacaf/kr vk'olr 2) tue lg;ksxh dk;zøe lhkh 'kkldh; vlirky ftles esfmdy d yst] ftyk vlirky] lkeqnkf;d LokLF; dsaæ] çkfkfed LokLF; dsaæ rfkk miloklf; dsuæksa es a ykxw fd;k tk jgk gsa bl dk;zøe ds varxzr%& çr;sd xhkzorh efgyk dks çlo ds nksjku çlwfr d{k esa vius,d efgyk ifjtu dks lkfk j[kus dh vuqefr gksxha lkeku; Js.kh ds çlo esa gh ;g lqfo/kk miyc/k gksxha fltsfj;u lsd'ku,oa bdykfe'k;k tslh flfkfr;ksa esa ;g vuqefr ugha gksxha tue lg;ksxh gsrq ik=rk%& xhkzorh efgyk ds }kjk p;fur ijhtu efgyk dks vuqefr gksxha fo'ks"kr% ek ] lkl] cgu tks çlwrk jgh gksa fdlh Hkh çdkj laøked jksx ls xzflr ugha gks rfkk lkq&lqfkjs dim+s igus gksa çlo dh çfø;k nksjku xhkzorh efgyk ds lkfk jgus rs;kj gksa,slh efgyk tks Lo;a dhkh çlwrk jgh gksa 10 P a g e I d e a l L a b o u r R o o m G u i d e l i n e, C h h a t t i s g a r h

tue lg;ksxh dh Hkwfedk%& HkkoukRed lefkzu ¼fujarj vk'oklu½ çnku djsaa vkjkenk;d Li'kZ] elkt] i;kzir rjy inkfkksa Z dk lsoua xhkzorh ekrk dh bpnkvksa dks nwljksa ds leeq[k Li"V djuka çlo çxfr ds ckjs esa ijhtuks dks voxr djkuka MîwVh ulz ds lykg,oa funsz'kksa dk ikyu djuk tue lg;ksxh bu phtksa ls cpsa%& fdlh nokbz ;k midj.k dks gkfk yxkuka ulz,oa M DVj ds dk;z esa ck/kk mriuu djuka xhkzorh efgyk dk eukscy fxjkuk,oa mls ijs'kku djuk vu; xhkzorh efgykvksa ds Vscy dh vksj u tkuk rfkk vu; tue lg;ksxh ls ckrs a u djuka bu flfkfr;ksa esa tue lg;ksxh dks çlo d{k ls ckgj Hkstk tk;sxka çlo laxh dk;zøe ds fø;kuo;u gsrq vlirky çeq[k gsrq fn'kk&funsz'k& çlo Vscy ds lehi csbus gsrq LVwy@dqlhZ dh O;oLFkkA,d ls vf/kd çlwrh Vscy d{k esa gks rks insz@ikvhz'ku cukdj çr;sd Vscy dks vyx djuka tue lg;ksxh dk;zøe dk çpkj&çlkj gsrq çlqrh d{k ds ckgj tkudkjh dk cksmz@ikslvj yxk;k tk;sa lelr LokLF; lalfkk,a tgk çlo djk;k tkrk gs] bl dk;zøe ds fø;kuo;u dh fteesnkjh lhkh eq[; fpfdrlk,oa LokLF; vf/kdkjh@flfoy ltzu@fodkl[k.m fpfdrlk vf/kdkjh@ vkj-,e-,- dh gksxha tue lg;ksxh gsrq fu/kkzfjr jftlvj gksxk tks yscj LVkQ }kjk la/kkfjr j[kk tk;sxka ftles tue lg;ksxh dk uke] eksckby ua] irk] xhkzorh ls fj'rk] xhkzorh efgyk,oa çlo laxh ds glrk{kj gksxka çlqrh d{k dh ulz }kjk ços'k ds le; tue lg;ksxh dks mldh Hkwfedk] nkf;ro] D;k djs& D;k uk djs bls le>k;k tk;sxk rfkk vko';d dsi& ekld,oa piiy miyc/k djkbz tk,xh rfkk vkbz& dkmz@ VSx tkjh djsxh ftlls tue lg;ksxh dh igpku vklkuh ls gksa çf'kf{kr uksmy M DVj,oa ulz vius lalfkk ds M DVj& ulz& vk;k dk tue lg;ksxh dk;zøe gsrq mueq[khdj.k djsaxsa çlo d{k dh ulz dk nkf;ro gksxk fd çr;sd çlo dk lgh fjd MZ j[ks rfkk f'k V cnyrs le; fjd MZ tk p ysa cpps dh vnyk& cnyh] LVkQ dk nqoz~;ogkj] cpps dk ykirk gksuk vkfn f'kdk;rksa ls cpsaa çlqrh okmz esa dk;zjr M DVj vksj uflazx dezpkjh tue lg;ksxh dks vko';d tkudkjh çnk; djsaxsa 11 P a g e I d e a l L a b o u r R o o m G u i d e l i n e, C h h a t t i s g a r h

12 P a g e I d e a l L a b o u r R o o m G u i d e l i n e, C h h a t t i s g a r h

14½ ekuo lalk/ku ds dro;z (Duty Chart) dzekad ekuo lalk/ku Lrj&1 (SHC/Non 24x7 PHC) 1,,u,e@ vkj,e, ¼xzkeh.k fpfdrlk [krjs dh ladsr dh igpkj o fjqjy lgk;d½ xhkzorh gksus dh tkwp izlodkyhu ns[khkky,lch, }kjk lkeku; izlo ¼ikVksZxzkQ],,eVh,l,y vkfn½ jsqj djus ds igys vkikrdkyhu izlo esa izkjafhkd fpfdrlk ¼,sDysEifl;k] ihih,p dk izca/ku½ izlo i'pkr 24 ls 48?kaVs rd vlirky esa izlqrk dk ns[khkky tkwp%& Hb, Urin albumin sugar, RD test tue ds rqjar ckn f'k'kq ns[khkky f'k'kq dks iksnuk] xez j[kuk] Ropk ls laidza Lruiku dh 'kq:vkra iquthzou ds lkfk vko';d uotkr ns[khkky 'kwu; fnol Vhdkdkj.k Sepsis,oa le; iwoz tue vkfn tvhyrkvksa dh igpku vksj lanhkzu ds iwoz izkjafhkd izca/kua chekj uotkr dk rqjar lanzhkua fjqjy lsok;sa izlo i'pkr~ ifjokj fu;kstu ds laca/k esa lykga dzekad ekuo lalk/ku Lrj&2 (24x7 PHC/Non FRU CHC) 1 LVkQ ulz [krjs dh ladsr dh igpkj o fjqjy xhkzorh gksus dh tkwp izlo iwoz ns[khkky izlodkyhu ns[khkky,lch, }kjk lkeku; izlo ¼ikVksZxzkQ],,eVh,l,y vkfn½ jsqj djus ds igys vkikrdkyhu izlo es izkjafhkd fpfdrlk ¼,sDysEifl;k] ihih,p dk izca/ku½ 15 P a g e I d e a l L a b o u r R o o m G u i d e l i n e, C h h a t t i s g a r h

izlo i'pkr 24 ls 48?kaVs rd vlirky esa izlwrk dh ns[khkky tkwp%& Hb, Urin albumin sugar,blood Grouping, Sickling,Blood Sugar, VDRL, HIV test, RD test tue ds rqjar ckn f'k'kq ns[khkky f'k'kq dks iksnuk] xez j[kuk] Ropk ls laidza Lruiku dh 'kq:vkra iquthzou ds lkfk vko';d uotkr ns[khkky 'kqu; fnol Vhdkdkj.k Sepsis,oa le; iwoz tue vkfn tfvyrkvksa dh igpku vksj lanhkzu ds iwoz izkjafhkd izca/kua chekj uotkr dk rqjar lanzhkua fjqjy lsok;sa izlo i'pkr~ ifjokj fu;kstu ds laca/k esa lykga 2 esfmdy vkwfqlj Assisted Normal Delivery tfvyrk dk izca/ku ¼jDr p<+kus ;k ltzjh lfgr Lrj 3 dh fjqjy tfvyrk ds vykok½ Episiotomy,oa mlesa Vkads yxkuk vikrdky esa izlwfr dh tfvyrkvksa esa izkjafhkd mipkj dj izfke lanhkzu bzdkbz@mpp fpfdrlk lalfkku esa Hkstuk vkikrdkfyu flfkfr esa tkwp%& Hb, Urin albumin sugar, Blood Grouping, Sickling,Blood Sugar, VDRL, HIV test, RD test lqjf{kr xhkzikr lsoka RTI/STI izdj.kksa dk izca/ku izlo ds i'pkr~ 48?kaVs rd vlirky esa BgjukA uotkr dks buqsd'ku ls cpkuka izh&vez izlo ;k le; ls igys ikuh dh FkSyh QwVus ij,uvhck;ksafvd nsuk] Corticosteroid nsuk A Hyper bilirubinemia okys cpps dks QksVksFkSjsih uotkr Sepsis dk izca/ku chekj uotkr vksj Low Birh weight Baby dk izca/ku,oa mpp lalfkku esa lanhkzua 16 P a g e I d e a l L a b o u r R o o m G u i d e l i n e, C h h a t t i s g a r h

dzekad ekuo lalk/ku 1 L=hjksx fo'ks"kk@cemonc izf'kf{kr fpfdrlk vf/kdkjh Lrj&3 (FRU CHC/CH/DH/MC) mijksdr drzo;ksa ds lkfk fueufyf[kr drzo;ksa dk fuozgu djsaxs%& PIH/Eclampsia,Sepsis,PPH,Retained Placenta, xahkhj jdr vyirk] vo:) izlo dk izca/kua fltsfj;u o vu; lftzdy fpfdrlka Blood Transfusion PPTCT lsoka ftyk fpfdrlky; esa fyad ART/ART HIV efgyk ladzfer efgyk dk izloa 17 P a g e I d e a l L a b o u r R o o m G u i d e l i n e, C h h a t t i s g a r h

15½ izlo d{k esa D;k djsa,oa D;k u djsa D;k djsa LVkQ ulz dh M~;wVh Shift cnyus ds le; midj.kksa ds fdz;k'khyrk dh tkwp efgyk dh xksiuh;rk vksj xfjek cuk, j[kuka izr;sd izlo ds fy, Sterlized midj.k dk mi;ksx izr;sd izlo Vscy ij ykbv dh lqfo/kk nks izlo Vsscy ds chp xksiuh;rk cuk;s j[kus gsrq IykfLVd ds inszsz yxkus pkfg,a izlo d{k drought eqdr gksuk pkfg,a tue ds,d?kavs ds Hkhrj f'k'kq dks Lruiku djkuka izlo ds fy, vko';d nokbz;kw dk 20% cqj LVkWd ges'kk miyc/k j[kuka izlo d{k dk rkieku 25&28 0 C lsfyl;l cuk;s j[kuk pkfg,a igkm+h,oa BaMh {ks=ksa esa BaM ds le; Room Heater dk mi;ksxa butsd'ku Oxytocin ¼vkDlhVkslhu½ dks fqzt esa j[kuk ¼fQztj esa ugha½ ladze.k jksdfkke izksvksdkwy dh izsfdvl RH ve ekrkvks a esa cord CyM dks,d= djuka D;k u djs vkyekjh,oa /kkrq ls cuh olrqvksa dks izlo d{k esa ugha j[kuk pkfg,a izlo d{k esa jks'kuh,oa rkieku ds fy, dks;yk ugha tykuk pkfg,a fpfdrld] ulz],oa tue lg;ksxh dks xkmu] piiy] ekld] dsi igus fcuk izlo d{k esa ugha tkus nsuk pkfg, nks izlo Vscy ds chp dim+s dk inkz ugha yxkuk pkfg, mles /kwy terh gsa izlo d{k esa vuko';d O;fDr;ksa dks izos'k ugha nsuk pkfg,a izlo dh fdz;k dks c<+kus ds fy;s isv esa ncko ugha Mkyuk pkfg,a izlo ihm+k c<+kus ds fy, fcuk fpfdrld dh lykg ds Oxytocin butsd'ku dks IM ;k IV drip esa ugha yxkuk pkfg,a ckj&ckj P/V Examination ugha djuk pkfg,a nkbz] ferkfuu] fj'rsnkj ls izlo ugha djkuk pkfg,a ;fn uotkr ugha jks jgk gs rks mls ihb esa] ryqos esa ugha ekjuk pkfg,a uotkr dks fcuk dim+s ds ugha j[kuk pkfg,a ;fn uotkr jsfm;suv okezj es gks rks mls vdsyk ugha NksM+uk pkfg,a 16½ izlo d{k ds lqy lapkyu ds fy, 10 eq[; dne%& 7 rjg ds Vªs dks arrange dj mi;ksx gsrq j[kuka izlo d{k esa vko';d midj.kksa dh fdz;k'khy volfkk esa miyc/krk tsls&izlo Vscy] B.P. Apparatus, LVsFksLdksi] fqvksldksi@mkiyj] ikvkszxzkq] Foot step, tue lg;ksxh ds fy, dqlhz] izlo d{k dks okrkoj.k ds vuqdwy j[kuk%& lkq&lqfkjk] rkieku] insz] f[km+dh] 'kh'ks yxs gq,] xksiuh;rk,oa 'kkspky; 24?kaVs ikuh lqfo/kk ds lkfka ;fn LokLF; dsunz esa fo'ks"kk,oa izf'kf{kr ekuo lalk/ku inlfk gs rks mugsa mpp tksf[ke okys ejhtksa ds ckjs esa igys ls crk dj j[ksa 18 P a g e I d e a l L a b o u r R o o m G u i d e l i n e, C h h a t t i s g a r h

uotkr f'k'kq ns[khkky bzdkbz%& izlo ds vk/ks?kavs iwoz jsfm;suv okezj dks pkyw gkyr esa j[kuk pkfg,a jsfm;suv okezj ds uhps fdz;k'khy resuscitation csx vksj ekld igys ls tkwp dj j[kuka Suction e'khu%& uotkr ds fy, Dee lees dks Vªs esa j[kuka ekrk ds fy, %& Foot operated/electrical suction e'khu ds lkfk Disposable ld'ku Catheter ds lkfk fdz;k'khy j[kuka vkwfdltu flysumj & vkwfdltu flysumj Hkjk gksuk pkfg, A can,oa pkyw djus ds fy, Key gksus pkfg,a izr;sd ckj vkwfdltu nsus ds fy, u;s V~;wc dk mi;ksx djuk pkfg,a vkwfdltu nsus ds iwoz V~;wc dks ikuh esa Mqck dj vkwfdltu gs vfkok ugha ;g tkwp dj ysuk pkfg,a gkfk /kksus okys {ks= es lkcqu,oa 24?kaVs ikuh dh O;oLFkk gksuh pkfg,,oa uy dks dksguh ds }kjk lapkyu ;qdr cukuk pkfg,a ladze.k jksd Fkke dh izfdz;k & Mªe esa nlrkus] midj.k] fyuu,oa xkwtihl j[kuk pkfg,a izlo d{k ds fy;s vyx ls vkwvksdyso dh O;oLFkk gksuh pkfg,a izlo esa mi;ksx es vkus okys midj.kksa dks dim+s es yisv dj mfpr la[;k es j[kuh pkfg,a ¼izfr izlo gsrq,d lsv½ 0-5 izfr'kr Dyksfju?kksy izfr fnu cukuk pkfg,a ftlesa Soiled Item dks Mwckus ds i'pkr~ vxyh izfdz;k ds fy, Hkstuk pkfg,a izlo d{k es dk;z djus ds nksjku O;fDrxr lqj{kk midj.k iguuk pkfg,a vif'k"v izca/ku (Waste Disposal) & vif'k"v izca/ku gsrq miyc/k dyj dksmsm fmccksa dks Hkj tkus ij rrdky,oa izfrfnu [kkyh djuk pkfg,a rjy vif'k"v dk izca/ku (Liquid Waste Disposal) vko';drkuqlkj djuk pkfg, & fjdkmz dk la/kkj.k & ikvkszxzkq] izloiath] fjqj bu@fjqj vkåv jftlvj miyc/k gksuk pkfg, o izfr izlo gsrq iw.kz :i ls Hkjk gksuk pkfg,a 19 P a g e I d e a l L a b o u r R o o m G u i d e l i n e, C h h a t t i s g a r h

17½ vknz'k izlo d{k dk izn"kzu 20 P a g e I d e a l L a b o u r R o o m G u i d e l i n e, C h h a t t i s g a r h

18½ vkn'zk izlo d{k esa SBA Protocol dk izn"kzu 22 P a g e I d e a l L a b o u r R o o m G u i d e l i n e, C h h a t t i s g a r h