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Re: Keillands: was Forceps IdentificationFrom: Garry E. Siegel (garrys@atl.mindspring.com)Thu Nov 14 19:15:24 1996
At 03:48 PM 11/14/96 -0600, you wrote: >I usually apply them by the direct application method. If I have trouble >with that, I will use the wandering technique. Only if all else fails will >I use the classical application(Twice in 30 years) No bladder lacerations >yet.
>R. Daniel Braun, MD FACOG
>On Thu, 14 Nov 1996, Richard Chudacoff, MD wrote: Dear Rick: For Kiellands, if it is OT, first ghost the forceps in front of the patient (never forget this--it is easy to get confused), and then I place the anterior blade classically (always cath the bladder first), and then place the posterior blade directly, or by wandering. I have wandered, but actually find that the forcep blade goes in well anteriorly. However, don't look up at the anterior abdominal wall when placing the blade! The Luikharts I referred to initially are used much like Simpson or classic forceps, with the advantage of the sliding lock for asynclitism, as Dan the man has pointed out. I was lucky enough to have trained at a place (U of Alabama, 1982-1986) where steel was king, and you had to pay a dollar to the chief resident if you used a vacuum (not really--just folklore). I'm sorry someone hassled Charlie on orals about Kiellands, and it is nice to see that people just out of training are still using them. Without low forceps with rotations (old mids or low mids for some), I think we would still do a few more sections. I photocopied about a hundred pages from an old forceps text (Dennen, I believe) about Kiellands, and have it somewhere. Ther is a relatively new text, Modern Instrumental Delivery, by O'Grady, that is good. If you are interested, email me privately or post to the list. If you want the old Kielland reference, or, gasp, a copy, let me know. Garry Siegel garrys@mindspring.com
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