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Re: indux

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Told you guys I was tired, and I'm sorry I left out some pertinent info...

To answer a couple of questions... I'm in a high risk L & D at a large taching

hospital where we have 4 residents & an Attending in house at all times, we

have a 3 suite OR dedicated to L & D with one scrub tech & one circulator

assigned each shift (although we can All circulate our own cases if need be,

and generally have 2 more scrub techs on the labor hall as well), Neonatal

Pediatric staff in RNICU, in-house Anesthesia coverage 24/7, and we are also

1:1 care with all patients on Pitocin. We are well equipped to handle

emergency C-sections when they happen.

This is the standard protocol for our inductions whether they are intact or

ruptured, primip, or multip, and even for PLTCS'. I admit, I hate the amount

of inductions and especially how many times we augment labor before really

giving the patient a chance to do it on her own. We do generally get good

results with this system though, and I don't see many having to go up to the

30 mu's, and Rarely see over that and then always with a working IUPC in

place, if you're smart. Believe it or not, we see Very Few uterine ruptures

with our patients on Pit, and the last one that I can remember, was on less

than 10mu.

Hope this helps!

Jenn

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Wow you give a lot more pitocin than i've ever given! We would mix 30 mu in

1000cc lr then start at .5mu/hr doubling every 1/2 hr up to 4 mu then up by

1-2 mu q 1/2 hr. with a limit of 20, we had to get an additional order to go

up to 30mu titrating to ctxn pattern of course. but we never go above 30.

It's amazing how different places do things different ways.

D

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Wowwie Dog,

Don't let our OB's hear that protocol!!!!!! That's scary to me. But like gmt says, maybe if you're in a tert. care center with available staff for stat c/s... Going up every 15 mins, you don't even know how she reacted to the last (15 min)!!! We go up by 2 mu every 30 min to 20mu. They do just fine. A huge percentage of our pts are induced. I hate it. I love to let them get up and move and shower and not trap them in the bed. Oh well, nothing's changing here! Chris

>>We all know that social inductons take forever,,we have one MD who admits them like crazy and won't let us give pit beyond 12mu..I always thought that the whole idea of an inducton was to get them delivered..not keep them in bed on pit for two days!!! He also has the highest c/s rate. Wonder why???? Lori <<Lori brought up a question I've been wanting to ask for a while now. After seeing several experienced L & D nurses come into our unit and gape at the rate we bump our pit, I'm beginning to wonder if we pit "harder" (for lack of a better word at the moment after the night from Hades) than other places or not. We start at 2mu, go to 4, then bump by 4's till 20 and then bump by 5's till 30mu's. After that, we have to have a special order to go on up to 45 if needed. We go up Q15min unless there is hyperstim, or we are adequate with an IUPC. So guys? How do y'all do it??? :: chuckles :: Inquiring minds want to know!Jenn :)Welcome to the OBnurses list!You have the freedom to change your membership settings at any time you choose. Go to the Onelist Home Page at www.onelist.com and sign in with your e mail address and the password you used to subscribe to this list. You will then see a list of all Onelist lists you are subscribed to. You can then easily choose the settings you would like--unsubscribe, digest, or Web-only.

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Yikes!!!I have worked in a few places but have never heard of bumping pit

that much at a time...We start at 2mu and increase by 2mu every 15 to 30 min

until we reach a max of 36....It has been my observation...after doing labor

and delivery for many years that if the patient is not in labor by 20 mu,

then they are not ready to be in labor . Anne M

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we titrate the pit starting at 2mu..going up every 30minutes..2mu...until

reaching 20mu......the physician has to order it to go higher...I would like

to ask I know we have hashed this before...however we obtained a letter from

Searle...reguarding cytotec for cervical ripening.....do you all have a

protocol in place, I called our local teaching hospital about their ( a

letter from their " chief " OB was submitted to our perinatal committee by

physicians seeking approval use) protocol...was told by the nursing staff

they do not have a protocol...the physician just writes the order...thought

maybe this was because of legal issues.....any thoughts...or do you have

protocols in place? and did any of you see the letter sent out stating that

cytotec was not for cervical ripening or labor induction....

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