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Re: shoulder dystocia

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Lori,

Keep your head up, you did the best you could do under the circumstances. Shoulder dystocia's are hard to deal with for the novice as well as the experienced nurse. You can bet the doctor was sweating too. Had one so bad once, the doctor pushed the head back into the pelvis and we did a stat section with a poor outcome for the baby. Never have or want to see that again. I saw an old book on delivery procedures back in the dark ages, they just crushed the head and pulled the body out in pieces, and the instrument used was grotesque. Thank God we live in advanced times for emergencies like yours and that we have the skills to assist the mom to deliver the baby alive.

Sandy

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Lori, these kinds of things can really make us upset. We are a nurturing

sort, and when things go badly, we take a lot of the feelings upon

ourselves. You can't make them go away, but you can only just tell yourself

that you did everything possible. And talk about it, whenever you need

to--helps disperse some of the emotions a bit.

--------Jeanine

[OBnurses] shoulder dystocia

> Help!! I had a severe shoulder dystocia in my delivery yesterday.

> Now I feel like I have post traumatic stress from it. If you have

> been unlucky enough to be the nurse in this kind of delivery, how

> have you dealt with all the emotions? I know it was not my fault,

> but I still feel guilty, angry, scared and like I let my patient down

> for not having the " normal " delivery. Any thoughts or suggestions

> would be appreciated. Thanks!

>

>

> Welcome to the OBnurses list!

> You have the freedom to change your membership settings at any time you

choose. Go to the Yahoogroups Home Page at www.yahoogroups.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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Guest guest

I've found the use of rectal misoprostol to be as effective, if not more

effective, than IM methergine. Admittedly, a lot depends on the individual

circumstances, such as, no to minimal stool in the rectum, and placement

against the anterior wall of the rectum as high up as possible (about 4 cms)

seems to be most helpful. Pt cooperation is a must. It's not as easy as a

quick jab with a needle and syringe, that's for sure. I make sure that

enough is stocked in the room for each delivery. I've used 200 mg. Is that

what everyone else is using? Any suggestions from anyone on this? My first

reaction to the use of this was roughly the same as when I was instructed to

use sl NTG to relax the uterus in a pinch. (Huh???) I am a fan of using

both now. I make sure we always have sl NTG in the room, too. Just a

thought, using sl NTG would be very helpful to relax the uterus enough in

assisting to slip that shoulder out if there is a possibility that it will

even slip out. Better that than a hemorrhage from a tear, or a severe

shoulder prob with the baby. The relaxment can always be reversed after the

babe is safely out...with good ole misoprostol!

Gay Marie

Be who you are and say what you feel...

Those who mind don't matter

and those who matter don't mind.

~Dr. Seuss~

[OBnurses] shoulder dystocia

> Hi,

>

> I am trying to put together an inservice to have nurses practice what to

> do in the event of a shoulder dystocia. Has anyone ever done this? Any

> ideas as to how to make it real?

>

> I did a great one a while ago for post partum hemmorhage. We had IV bags

> full of red water and black cherry Jell-O. I wore white makeup ans

> sprayed my face with water to be " sweaty " . I made " uteruses " from bags

> of sugar so everyone could feel a firm versus boggy fundus. It was a

> real hoot and everyone enjoyed themselves.

>

> Also, has anyone ever used rectal misoprostil for postpartum hemmorhage?

>

> in Connecticut

>

>

> Welcome to the OBnurses list!

> You have the freedom to change your membership settings at any time you

choose. Go to the Yahoogroups Home Page at www.yahoogroups.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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