Placement Procedure
Preparation
Explain the procedure, the indication for that individual patient, risks and benefits, and obtain verbal consent.
Wash both hands thoroughly.
Open electrode package or have an assistant (nurse) do it.
Put on appropriately sized sterile gloves.
Examine electrode to ensure that the wires are intact and that the electrode can slide from the sheath. Pull the distal tip of the wire back into the sheath about 2mm, so it does not extend beyond the sheath.
In this image: A fetal scalp electrode.
Placement
Perform a vaginal examination, confirm vertex presentation and location of the fontanels. Feel for firm bony areas and avoid the fetus's face, sutures, fontanels.
While maintaining your fingers on the target area, take the FSE from the sterile wrap and hold it in your non-examining hand but leave the plastic sheath on to help with placement (see Figure 2 below, shown with plastic sheath removed).
In this image: Figure 2. The clinician holds a FSE.
Place the distal end of the FSE introducer sheath between the second and third fingers of the examining hand and advance between these fingers until it is firmly placed against the fetal head at a right angle (see Figure 3 below).
In this image: Figure 3. The FSE introducer sheath.
Again ensure that you have avoided the fontanels, suture lines, and the maternal cervix.
Maintain pressure against the fetal scalp and turn the proximal end of the electrode complex clockwise (about two to three times) with the non-examining hand until resistance is met.
Release wires from the lock devise on the proximal end and slide the plastic sheath over the wires (see Figure 4 below).
In this image: Figure 4. Releasing the lock device on the FSE.
Connect the electrode to the secured plate on the patient’s thigh and plug cable into the monitor (typically done by the nurse) (see Figure 5 below).
