Nasg Proc Surgery Ind Learn Fac
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hunde 4motherNASG
PROCEDURES
& SURGERY
Performing Procedures & Surgery
for Women in the NASG
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NASG ▪ PROCEDURES/SURGERY
Performing Procedures & Surgery
for Women in the NASG
Vaginal Procedures with the NASG Applied
The NASG is designed to permit complete perineal access. The source of most obstetric
haemorrhage can be located and treated while the garment maintains the woman’s pulse and
blood pressure, decreases blood loss, and maintains tissue oxygenation. Urinary catheterization
can also be performed with the NASG in place.
NASG permits complete
perineal access
The following vaginal, genital or urinary procedures can be performed
on a woman in the NASG:
1. Placement of straight catheter or 5. Bimanual compression (external or
indwelling urinary bladder catheter internal)
2. Placement of balloon tamponade 6. Dilation and curettage (D&C) or
Dilation and evacuation (D&E)
3. Repair of episiotomy or vaginal and
cervical lacerations 7. Manual vacuum aspiration (MVA)
4. Manual removal of the placenta
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IND LEARNER | FACILITY | NASG PROCEDURES/SURGERY | Page 2
Any vaginal procedure can be
performed with the NASG in place
Abdominal Surgery with the NASG Applied
If the patient requires surgery, she should remain in the NASG for the surgery. The abdominal
and pelvic segments (#4, #5, and #6) may be opened, but only immediately before the first
incision. The anesthesiologist or anesthetist needs to be ready to administer boluses of IV fluids
for any blood pressure drop when the abdominal segment is opened.
Hemostatic surgeries that can be performed with the NASG in place,
but abdominal segments opened, may include:
1. Cesarean section (of a non-viable 6. Laparotomy
fetus) 7. Laparoscopy
2. Repair of ruptured uterus 8. Removal of placenta accreta
3. Hysterectomy 9. Repair of broad ligation hematoma
4. Salpingectomy/salpingostomy 10. B-Lynch or other uterine
5. Ligation of arteries compression sutures
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IND LEARNER | FACILITY | NASG PROCEDURES/SURGERY | Page 3
NASG ▪ PROCEDURES/SURGERY
STEP 1
Clinicians (such as circulating nurse or surgery technicians) should open segments #4, #5 and #6
immediately before surgery. When these segments are open, the patient may go back into
shock. The anesthesiologist/anesthetist may need to give IV fluid boluses to maintain blood
pressure until hemostasis is achieved.
Open segments #4, #5, and #6
immediately before surgery
Anesthetist/anesthesiologist should be prepared to give
IV boluses when the NASG is open
Safemotherhood.ucsf.edu © 2013 SUELLEN MILLER
IND LEARNER | FACILITY | NASG PROCEDURES/SURGERY | Page 4
NASG ▪ PROCEDURES/SURGERY
STEP 2
If necessary, the staff should place the patient in Trendelenberg position.
STEP 3
The clinician should perform the surgical procedure(s).
STEP 4
The clinician should replace segments #4, #5, and #6 as soon as the surgery is complete.
Replace segments #4, #5, and #6
as soon as the surgery is complete
Materials for Practice
1. NASG Video (procedures/surgery training are in the NASG training video at the 5 minute
and 36 second mark (5:36))
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NASG ▪ PROCEDURES/SURGERY
Knowledge Assessment
See if you can answer these questions correctly. After you have marked your answers look below
for the correct answers. If you did not answer any of the questions correctly, go back to the
section about that topic and review.
1. Urinary catheterization cannot be performed with the NASG in place. (True/False)
2. Which of the following vaginal procedures are possible with the NASG in place? (Tick all that
apply.)
a. Repair of vaginal/cervical lacerations
b. Manual removal of placenta
c. Bimanual compression
d. D&C or D&E
e. MVA
3. The NASG should be completely removed for surgery. (True/False)
4. The abdominal segments should be opened immediately before abdominal surgery.
(True/False)
5. When should the abdominal segments be closed after surgery?
a. Two hours after surgery
b. Immediately after surgery
c. The abdominal segments should not be closed after surgery
Safemotherhood.ucsf.edu © 2013 SUELLEN MILLER
IND LEARNER | FACILITY | NASG PROCEDURES/SURGERY | Page 6
NASG ▪ PROCEDURES/SURGERY
Knowledge Answers
1. Urinary catheterization cannot be performed with the NASG in place. (True/False)
Answer: False. Urinary catheterization CAN be performed with the NASG in place.
2. Which of the following vaginal procedures are possible with the NASG in place? (Tick all that
apply)
a. Repair of vaginal/cervical lacerations
b. Manual removal of placenta
c. Bimanual compression
d. D&C or D&E
e. MVA
Answer: ALL of the listed procedures can be performed with the NASG in place. ANY
vaginal procedure can be performed with NASG in place.
3. The NASG should be completely removed for surgery. (True/False)
Answer: False. Only the pelvic and abdominal segments (#4, #5, and #6) should be
opened immediately before abdominal surgery begins.
4. The abdominal segments should be opened immediately before abdominal surgery.
(True/False)
Answer: True
5. When should the abdominal segments be closed after surgery?
a. Two hours after surgery
b. Immediately after surgery
c. The abdominal segments should not be closed after surgery
Answer: b. Immediately after surgery
Safemotherhood.ucsf.edu © 2013 SUELLEN MILLER
IND LEARNER | FACILITY | NASG PROCEDURES/SURGERY | Page 7
