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Safety messaging regarding the use of plastic cord clamps at caesarean section

Published: 29/09/2020

Situation

Plastic cord clamps are being used, in some maternity units, in place of Spencer Wells forceps, to clamp the umbilical cord following birth at caesarean section.

Background

Following an incident regarding a Spencer Wells forcep cutting through an umbilical cord, it was identified that a small number of maternity units have changed their local practices and now use a plastic cord clamp to clamp the umbilical cord following birth at caesarean section.

Assessment

These cord clamps are not radiopaque and therefore would not be visible on X-Ray if they were to be retained during a caesarean section.

The National Safety Standards for Invasive Procedures (NatSSIPs) stipulates, under section 4.11 ‘Prevention of retained foreign objects’, that  Local Safety Standards Standards for Invasive Procedures (LocSSIPs) should ‘cover all potentially retainable items used in procedures.’

Recommendation

If used, plastic cord clamps must be counted in the instrument count, both prior to and following the caesarean section in accordance with section 4.11 of the National Safety Standards for Invasive Procedures.

Please see NHS Engand's additional resources on NatSSIPS (PDF).

The scrub practitioner should be responsible for including the device in the counting procedure.

The Association for Perioperative Practice (AfPP) provide information on accountable items, swab, instrument and sharps count.