Removing sutures and calculating delivery dates
The artwork that would've put Picasso out of work
Removing Sutures:
I was given the chance to remove sutures from a woman who had undergone surgery. Sutures? Sounds easy right? So simple, bla bla bla.. don’t get me wrong, it is simple but I can see why it would require attention to detail and good clinical practice.
The woman I had to remove the sutures from, seemed to have a small infection in the site, nothing crazy like an abscess, but there was some discolouration and the site was tender to the touch. All this meant that I had to be super careful with how I remove the suture. Thankgod that the consultant watching over was nice and guided me along the way.
How to remove sutures?
Hold the needle holder on your non-dominant hand (make sure to practice this regularly, because it was a first time for me and I struggled for a bit)
Hold the scalpel in your dominant hand
With the needle holder, hold one end of the suture and pull up, or manoeuvre left and right and up until you can make some space underneath the suture
Once you have enough space for the scalpel to fit, place the scalpel underneath the space with the scalpel either facing you or away (whichever is the safest and won’t cut the patient or you or anyone around)
MAKE SURE you have good control of your scalpel when you make the cut. Don’t just cut with full force, because you may end up hurting the patient or cutting someone else assisting you.
Cut on the left or right of the knot, never cut ON the knot.
Once cut, use the needle holder to pull the suture out
Ways to determine gestational age (GA):
I was asked this question and then quizzed on it, so I might as well give you some of the information.
Two main ways to determine GA:
Using the last menstrual period (LMP) date
Ultrasound
Which one is the most reliable? 1 or 2? Don’t cheat, scroll down for the answer
Ultrasound is the most reliable and accurate. AKA the A-scan.
The LMP method is known as Naegele’s rule and it works in 3 steps:
Determine the first day of your LMP
+ 7 days and subtract 3 months
Then add a year
That is your expected delivery date
So if your first day of the LMP was 1st of November, you would subtract 3 months = 1st September. You would add 7 days = 8th September. Add a year = 8th September 2021
This method has a few limitations though:
The patient may not be able to remember her LMP or the first date
This method assumes all women have 28-day cycles, so it may be incorrect for women who don’t
A woman could confuse the first day of LMP with 1st-trimester regular bleeding
Therefore, the ultrasound is more accurate, however, the ultrasound scan also known as the A-scan can only be done before Week 13 + 6 days of the pregnancy. After that, there are other ways to determine GA.
https://www.hopkinsmedicine.org/health/wellness-and-prevention/calculating-a-due-date
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