Identify the image showing in the picture?& x20; - AIIMS Rishikesh & Jodhpur NO - 2017

AIIMS Rishikesh & Jodhpur NO - 2017

Obstetrics & Gynaecology

Medium

Appeared in: AIIMS Rishikesh & Jodhpur NO - 2017

Explanation

The instrument shown is an episiotomy scissor, which is specifically designed for performing an episiotomy.
Its most distinct feature, clearly visible in the image, is the angled blades.
One blade has a blunt, flattened tip that serves as a protective barrier, shielding the baby's head from injury during the incision.
This specialized design allows for a safe and precise cut of the perineum to facilitate delivery.

Option B: Allis forceps are grasping instruments, not cutting instruments. They have sharp, interlocking teeth at the tips used to hold or retract heavy tissue.
Option C: Mayo scissors are heavy surgical scissors used for cutting thick tissues like fascia or sutures. While they can be curved, they do not have the characteristic angled blades and protective blunt tip of an episiotomy scissor.
Option D: Tooth forceps are a category of grasping instruments characterized by teeth at the tips for a secure hold on tissue. They are not scissors and are not used for cutting.

Clinical Relevance

Nursing practice connection: Use the key finding related to Identification of surgical instruments used in obstetrics to guide bedside assessment, documentation, and the next nursing action.
Using the correct surgical instrument is paramount for patient safety. Using a standard scissor like a Mayo scissor for an episiotomy could lead to a serious laceration injury to the baby's scalp or face.
Nurses play a critical role in the operating room and delivery suite by preparing surgical trays, ensuring the correct instruments are available, and being able to identify them for the practitioner.
What if? If an episiotomy scissor is not available, the procedure might be deferred if possible, or the practitioner would have to proceed with extreme caution using a different instrument, significantly increasing the risk of fetal injury. This highlights the importance of proper equipment preparation.

How to Approach the Question

First, identify the general category of the instrument in the image. You can see it has finger rings and two blades that pivot, so it is a type of scissor.
Next, carefully observe the specific features of the blades. Notice that the blades are not straight but are set at an angle to the handles.
Look closely at the tips of the blades. You will see that one blade is sharp, and the other has a blunt, flattened end.
Consider the purpose of these unique features. The angle allows for easier access and cutting in the perineal area, and the blunt tip is a safety feature to protect the baby.
Evaluate the given options. 'Episiotomy scissor' is specifically designed for this purpose with these features. The other options are either grasping tools (forceps) or general-purpose cutting scissors (Mayo) without these specific adaptations.

Concept Tested & Keywords

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E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 18-26

E6 Gynecology Williams p. 429-435