[hejn0006]

Hi, I'm the educator for our Obstetric unit, we do 60 deliveries a month. Staff is uncomfortable collecting cord blood gasses, also interpreting the results. Any ideas for a competency, or good reference articles or books
Thanks,Doris

[33-weeker]

Collecting them is not that big a deal, just draw from a freshly clamped/cut length of cord into a ABG syringe and put on ice until resp. comes to get it. As far as interpreting the results, I would think that would be up to the doctor(s). By the time you get the results, the baby will have been stablaized by NRP guidelines regardless of the results.

My experience with cord gasses is that it is more a predictor of the baby's condition at birth and overall prognosis (likelyhood to have brain damage, seizures, etc...), not results used to make direct treatment decisions. We treat according to the actual ABG results from baby in the level II, if the baby is still compromised at that time (ie. on O2 or vent.). If the baby is on room air and ok by then - we just watch the baby.

[SmilingBluEyes]

Where I work, we take the clamped/cut cord, place it on ice, call Cardio-pulmonary staff to come and process it STAT------these folks draw it up and take the blood to the lab for a reading on the gases. It's worked well for years now. Nursing staff are busy doing other things like circulating the delivery and assisting the OBs, as well as receiving/resuscitating babies; we don't collect the cord gases on top of that, where I am. The ones who are trained and know well how to do this, do it, and that way there are no mistakes and no time wasted.

[33-weeker]

Try these:

http://www.utmb.edu/lsg/labsurvivalg...S_ANALYSI2.htm

http://findarticles.com/p/articles/m...8/ai_109265347

http://www.obgyn.net/jr/jr.asp?page=review14

[33-weeker]

Originally Posted by SmilingBluEyes

we don't collect the cord gases on top of that, where I am.

For what it's worth, I don't see it done much here either. We are a medium-size hospital, but not in Med center, and only have level I & II nurseries. We do about 225 - 250 births a month.

(must be nice to only do 60. :-)

[SmilingBluEyes]

We do about 65-70. Smaller community hospital here.

[OBGYN Legal RN]

First off, staff can't be allowed to be afraid to interpret the results. That is a must!!! Right now my staff does couplet care, and my nurses darn well better be able to interpret. Drawing, it takes knowledge first, too many untrained go for the big vessel because its easy, techs, lab personnel, etc. so my nurses do it. A clamped cord can sit for 30 minutes NOT on ice, and be fine. Look it up, now ACOG is saying no ice due to new istat machines, etc. There are some great books out there on gas interpretation, but nothing does it better than knowing the physiology as well, so don't leave that part out. Good luck.

[eden]

We do routine cord gases on all babies and the nurses do the collection. Why not have a training session for the staff to do the collection/interpretation or have the staff collect them on every baby just to practice.

[OzMW]

We do our own cord blood collection for gases. A good way of practising is to let them 'play' with a few cords in a workshop type scenario so there is no pressure. And a good way to remember which vessel is which and how many there are- think a woman has two arms (arteries) and one vagina (vein)!