[epiphany]

My pt. pulled out her IV during delivery and I had to give her a pitocin inj 10 units sc. Just wondering how this handled by other hospitals?

[OBNurseryRN2006]

We will give 10 Units IM after placenta if pt has no IV. Never heard of giving it Sub-Q.

[daisybaby]

Never heard of SC either. We do 10u IM after placenta as well.

[lisamct]

We give Syntocinon 10iu IM before placenta is delivered with the delivery of the babies anterior shoulder, never heard of it given SC (most of our women dont have IV's in situ).
Is it routine to give Synto/Pitocin after delivery of the placenta in the US, we would always aim to give it before?

[Spidey's mom]

We give 10 units of Pitocin IM after delivery of the placenta. Never heard of SQ either.

steph

[LizzyL&DRN]

We had one Doc that liked 10units of Pitocin IVP with delivery of anterior shoulder. There are some studies that suggest a decrease in risk of postpartum hemorrhage with this type of administration.

We also give 10 units IM if no IV access is avail (mom pulled out or she came in and delivered before we can get it in). Never heard of SC either.

[crosfam]

We add 20 units pitocin to 1 liter of IVF following delivery of placenta and allow the liter to infuse at bolus rate.

[ragingmomster]

Seems our unit can go either way.

Most of our pt's have an IV placed immediately upon confirmation of active labor (i.e. cervical change).

It is usual to have 20 units pitocin mixed in 1 L NS and it is infused as the main line IV after delivery of the placenta. Some of the more forward thinking MD's and midwives are starting the pitocin after delivery of the anterior shoulder now, but it's not common.

As for the rate of infusion it is usually written as 125ml/hr x 1 or 2 liters, but the rate can be titrated by the RN in the recovery period depending on lochial flow and fundal bogginess.

I have used IM Pitocin several times in the case of precipitous deliveries, and one or two midwife pt's who refused iv's. Depending on parity and expected uterine atony related to parity, the dose is either 10 or 20 units IM after delivery of placenta.

[nurse_atnite]

Originally Posted by crosfam

We add 20 units pitocin to 1 liter of IVF following delivery of placenta and allow the liter to infuse at bolus rate.

If IV access is not available, we use 10 units Pitocin IM....just like most hospitals.

[LDRNMOMMY]

Originally Posted by epiphany

My pt. pulled out her IV during delivery and I had to give her a pitocin inj 10 units sc. Just wondering how this handled by other hospitals?

Our floor uses 30 units in 500 ml, and one bag gets bolused after the placenta then one bag @ 125 ml/hr. We also give it IM when moms precip without IV access or IV gets pulled out.

Our pharmacy went to 30 in 500 in an effort to reduce medication errors (it works out to 1 milliunit:1 ml)