Skin-to-Skin in the OR Concerning Vitals Temp < 36.3 Temp > 37.5 The Mizzou Standard of Care Call 4th Floor to alert them of impending delivery Inform mother that infant will be resuscitated by NICU and will go to NICU Decision to do Cesarean Section NO YES Mother/Baby candidate for S2S? Baby is born & goes to warmer in resuscitation room Keep mother up to date on baby’s progress – begin pumping and hand expressing in recovery room NO Baby to NICU or NOU Newborn team resuscitates & evaluates baby (obtains weight) NO NO Send colostrum to NICU for oral care Inform mother of baby’s status and where the baby is going Baby Stable? YES Record in chart: Hand expression taught Time that pumping/hand expression performed Newborn team calls transition nurse (TN) to resuscitation room (if not there already) Call for baby update from NOU Encourage mother to do S2S immediately upon being reunited with her infant Infant Stabilized? TN takes newborn into OR & places infant skin to skin YES Baby to NICU or NOU Infant returned to mother in PACU NO TN continually assesses: Breathing Color Tone Cry Stability of infant on chest Bulb suction and stimulates as needed In order to keep warm, baby must be skin-to-skin with either mother or support person, wearing a hat & both covered with warm blanket NO At 30 minutes, TN performs Vitals (Temp, Pulse, Resp) YES Stable? Stable? YES At 1 hour of life: 1 - administer eye ointment And vitamin K injection 2 – Perform second set of vitals When surgery completed, roll baby with mother TN will support infant (each time baby removed from S2S, infant cools and is stressed) Infant to PACU in mother’s arms Teach mother: Feeding cues Importance of S2S Biologic Hold Hand expression Assist baby in latch Concerning Vitals Temp < 36.3 Temp > 37.5 HR < 100 HR > 170 Resp < 35 Resp > 65 Once mother/infant stable and PACU nurse comfortable, call up report to NOU and record information: Record that infant went S2S Record infant vitals Record newborn weight Record administration of eye ointment and Vitamin K Infant transferred to 4th floor in mother’s arms Newborn bath and assessment occur in mother’s room