Our maternity wards have sturdy steel cots. They used to elevate the foot end of the cots in certain obstetric situations in the past, most of which are not considered valid indications for giving a head-low position in modern times. They used to put wooden blocks under the legs of the cots to achieve this. If the wooden blocks were kept vertical, the head-low used to be steep. If they were kept sideways, it used to be mild. We do have special situations in which a head-low position is still required, such as hemorrhagic shock and fetal umbilical cord prolapse. We have special cots for this purpose, which have mechanical arrangement to give head-low position. A steep head low position using wooden blocks is shown in the following 3D model I made to illustrate the point..
We have one consultant who still uses this old time arrangement, for the old time indications. The nurses have not thrown away the old wooden blocks, and they prove useful to this consultant. This position is so uncomfortable, that the patients dislike it intensely, and resort to some other use of the arrangement as is evident from the following comments made by different faculty members after looking at such cots.
"Look at that woman. She is sleeping in head-high position. The Boss' round must be over. Or she would not have dared put her head at the foot end of the cot" I heard on one such occasion.
"Perhaps he/she has prescribed this position to accelerate labor, reverse of head-low position to control preterm labor" someone sniggered.
"Where is the patient on this full-block head-low cot?" I heard on another occasion.
"She is sleeping on the adjacent vacant cot" someone answered with a smile.
"Oh, look at that child enjoying itself on a slide" I heard on a third occasion. Everyone looked. A small child was climbing at the foot end of the cot, and sliding down the length of the cot over the smooth McIntosh that was placed over the mattress. Its mother was sitting on an adjacent cot, watching her child with love.
"I bet the child loves visiting its mother in the hospital more than going to the garden. Here it gets the company of the mother and a slide all to itself" someone said. That actually seemed to be the case.
We have one consultant who still uses this old time arrangement, for the old time indications. The nurses have not thrown away the old wooden blocks, and they prove useful to this consultant. This position is so uncomfortable, that the patients dislike it intensely, and resort to some other use of the arrangement as is evident from the following comments made by different faculty members after looking at such cots.
"Look at that woman. She is sleeping in head-high position. The Boss' round must be over. Or she would not have dared put her head at the foot end of the cot" I heard on one such occasion.
"Perhaps he/she has prescribed this position to accelerate labor, reverse of head-low position to control preterm labor" someone sniggered.
"Where is the patient on this full-block head-low cot?" I heard on another occasion.
"She is sleeping on the adjacent vacant cot" someone answered with a smile.
"Oh, look at that child enjoying itself on a slide" I heard on a third occasion. Everyone looked. A small child was climbing at the foot end of the cot, and sliding down the length of the cot over the smooth McIntosh that was placed over the mattress. Its mother was sitting on an adjacent cot, watching her child with love.
"I bet the child loves visiting its mother in the hospital more than going to the garden. Here it gets the company of the mother and a slide all to itself" someone said. That actually seemed to be the case.
