Active management of 3rd Stage of Labour (AMTSL)

Management of 3rd stage of labour:

  1. Within 1 minute of delivery – Oxytocin 10 ml I/V or I/M is given.
  2. Deliver the placenta by Control Cord Traction (CCT).
  3. Examination of placental membrane.
  4. Fundal massage.

Other related questions and answer:

CCT(Control Cord Traction)/ Brandth Andrew’s method:

The left hand is placed over the abdomen and push-up the fundus towards the umbilicus. And  hold the umbilical cord with right hand and give very slight traction. And deliver the placenta.

Why Placetal membrane is examined?

To see whether the parts of placenta is retained or not in uterus.

Allis Tissue Forceps

Alli's Tissue forceps

Instrument (Allis Tissue Forceps)


  1. Identifiy it?
  2. Identifying Points?
  3. Uses?
  4. Advantages?
  5. Sterilization?
Allis Tissue Forceps
Allis Tissue Forceps


1.Allis Tissue Forceps

2.Identifying Points:

  • Catch at the handle
  • Tips curved inwards with multiple teeth and socket
  • Gap is more pronounced in the shaft of the blade

3. Uses:

  • To hold tough structures like skin and fibrous sheath.
  • To hold soft structures like stomach/ jejunum/ Urinary Bladder etc.


  • It does not crush the structures during holding.
  • There is less damage of the tissues than artery forceps.
  • No vascular impairment to the tissue holding.

5. Sterilization: By Autoclaving

Examination Of Pulse In Clinical Medicine

Radial Pulse Clincal Procedure


Pulse means the expansion and elongation of arterial walls passively produced by the pressure changes during systole and diastole of ventricle.

 Different Pulses:

  1. Radial pulse
  2. Brachial pulse
  3. Carotid pulse
  4. Femoral pulse
  5. Popliteal pulse
  6. Posterior tibial pulse
  7. Pulse of arteria dorsalis pedis


  1. Rate
  2. Rhythm
  3. Volume
  4. Character
  5. Condition of arterial wall
  6. Symmetry
  7. Radio-femoral delay

Findings of different characteristics:

  • Rate, Rhythm & Condition of the vessel wall: by Radial artery.
  • Character & Volume: by Carotid pulse.
  • Symmetry: by Simultaneous assessing both right & left radial pulse.
  • Radio-femoral delay: by Simultaneous assessing of right radial pulse & right femoral pulse.

Radial Pulse :

Radial Pulse Clincal Procedure
Radial Pulse examination

At wrist , lateral to flexor carpi radialis tendon , place your three middle fingers over the radial pulse.

Brachial Pulse:

Brachial Pulse- Clinical procedure
Brachial Pulse Examination

In antecubital fossa medial to biceps tendon. Use your thumb with your fingers cupped round the back of elbow.

Carotid Pulse:

  • Palpate carotid pulse with the patient lying on a bed / couch
  • Never compress both carotid arteries simultaneously.
  • Use your left thumb for right carotid pulse & vice versa.
  • Place tip of thumb b/w larynx & ant.border of sternocleidomastoid.

ECG Notes Interpretation and management guide

ECG Notes Interpretation and Management Guide

This book contains:

  • ECG Basics
  • 12-Lead Interpretation
  • Clinical Tips

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  • All the ECGs are described in different categories, so that reader can easily search out the topics.

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Types of Needle

Round Curved needle with thread

A) According to edge of needle:

  1. Round body
  2. Cutting body

B) According to shape of the needle:

  1. Straight
  2. Curved- 1/2 circle, 3/8th circle etc

C) According to fixed with thread or not

  1. Atraumatic (with thread)
  2. Traumatic (without thread)


  1. Curved round body needle is used in suturing peritoneum, broad ligament pedicles, cut margins of the uterus and the vaginal wall during episiotomy.
  2. Curved cutting body needle is used in suturing skin, rectus sheath, vaginal wall and reconstruction of the cervix after amputation etc.

N:B: Use straight needle is limited. It can be used in skin suturing.

Round Curved needle with thread
Atraumatic(with Thread) round Curved Needle

Instruments use in Gynae & Obs

Vaginal Speculum

Instruments use in Gynecology & Obstetrics




See more picture




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