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Clinical Vignette Template 3 -Form Fill

INFORMATION
Q01

Vignette form no.
Q02

Name of interviewer
Q03

Place of Interview
Q04

Date
Q05

Designation
Q06

Age
Q07

Gender
Q08

Type of Facility
Immediate care after childbirth
A01

Put the child directly on the mother’s abdomen/chest (Skin to Skin care).
A02

Check if the baby is crying.
Resuscitating the baby (initial steps)
B01

Immediate cord clamping and cutting
B02

Immediately place newborn in the radiant warmer.
B03

Neck is slightly extended using roll under shoulder.
B04

Clear airway by suctioning mouth and nose.
B05

Stimulate the child by rubbing the back of the child.
Resuscitating the baby
C01

Initiate bag and mask ventilation.
C02

Provide five ventilatory breaths and look for chest rise.
C03

Recheck for any air leak from the bag and mask and from the seal of the hand, readjust the neck extension.
C04

Provide ventilation again.
C05

Continue providing ventilatory breaths for 30 seconds.
C06

Reassess breathing of newborn.
Observational Care
D01

Place child in prone position on the mother’s chest.
D02

Initiate breastfeeding
D03

Cover mother and baby appropriately to prevent hypothermia.
D04

Monitor the vitals now and then every 15 minutes in the first hour.

D05

Monitor color of newborn.
D06

Shift mother and child to the ward.
D07

Reassure the mother and provide counselling on breastfeeding and skin to skin contact care. 
Differential Practice
E01

Please elaborate what made you diagnose this as a case of (diagnosed condition). Why did you suggest this treatment?