[Eagle Fan]

Our pumps have removable channels. Each pump can control up to four channels. We run everything through the pump. LR@125 is always the mainline. Pit gets a channel and runs into the mainline closest to the vein. Antibiotics run from a secondary above and through the LR channel. The LR does not run when the secondary is running. We start our Pit to run at 2mu/min which is 6ml/hr and then back the LR off to 119ml/hr so the patient does not receive more than 125mls per hour. If we up the pit we back off the LR. If patient is on Mag, we add Mag 50ml/hr + Pit 6ml/hr + LR 69 ml/hr and so on. The antibiotics are not figured into the mess because they usually run at a lower rate.

[CEG]

Originally Posted by njmcavoy

So you have your IVF's and your pitocin both on the pump?? (and antibiotics if you have them) How do you set it up??

We have triple pumps on our unit.

[rnheart]

To Keep Open, no question is stupid

[eandgsma]

Originally Posted by htrn

I agree with the last poster. Start your main line fluid with blood/anesthesia tubing and run by gravity at whatever rate is appropriate - the old fashion way, drip count. Then run your pit through the pump and hook into the closest port. There is no need for another bag of fluid - that's just a waste. One bag on anesthesia tubing for mainline and emergencies/bolus and your pit bag through your pump.

This is what we do with regular tubing with ports. The pit is on portless tubing. We have >8k deliveries a year and yes, everyone gets pit. We have cartridges so we can add on to the pump if needed. Usually, we have LR running to gravity and pit to the closest port. If we need to turn off the pit, we turn off the channel (cartridge). There isn't that much left in the tubing going to the patient because its at the closest port. I'd have to measure it but it can't be more than 8 inches of tubing. It would be interesting to really find out how much is in there. Anyway, we run the boluses out of the primary bag of LR. Rarely do we put our LR on a pump, sometimes if we have to run Pen GK we will because it hurts going in. We would always put the LR on a pump for a mag pt though. But we have to dig for channels usually so they are not used as often.

On another subject (but re: pitocin), I so much more prefer it to cytotec. At least we CAN turn off the pit. You can't get rid of a dissolved pill when mom is hyperstimulating.

[carriedf]

I'm new to this site so forgive me if I'm doing this wrong....I have been an OB nurse for 6 yrs and when I was trained i was told that you always run pitocin through a pump on its own line and always attach it to the port closest to the patient. NEVER SECONDARY!! Now I get a new job 4 mo ago at a larger hospital and because DPH and JACHO have been around we now have to run our LR on a pump vs free flow. So some of the nurses there have been piggy backing the pitocin into the LR instead of keeping it on its own line. They will set the primary line at say 119cc/hr and then the secondary at 6cc/hr and titrate as necessary. I am having such a hard time with this because i feel that there is such a huge risk and potential for accidentally bolusing a pt with pit. Now, because the hospital doesnt want to supply us with double pumps, they are rewriting the policy to state that pitocin needs to be secondary to the primary line of LR. I am refusing to do it that way because if feel its not safe. Does anyone know of any policies from awhonn or acog that would support running pitocin on its own line and attached closest to the vein? Thank you in advance!!!

[PCmom]

We have 3 channel pumps. maint. iv is the first channel. Pitocin is 2nd. 3rd only used if pt is on mag or insulin. We hook the mant. in one port of the hep lock and the pitocin in the other. If we need to bolus we just take the maint. off the pump and run it. The maint. also has Anesth. tubing on it in case of emergent c/s.

[kathiecnm]

We are going to the ACOG recommended 1:1 pitocin concentration soon at two local hospitals. This should be easier & safer for the nurses since there are no calculations involved for either induction or augmentation of labor. My two questions however are:
1. What is your "bolus" rate for immediately after delivery of the placenta?
2. How many bags of the higher concentration do your OBs want for the PP period?
We had 2 bags at 125mL/hr of the old concentration (20u in 1000mL)= 42mL/hr of the new concentration (15u in 250mL), but can't find any recommendations of how much to run. Don't you just love all the questions with no clear answers in OB?

[carriedf]

After the placenta we have 20u pit in 1000cc LR and run it wide open..there has been talk that we will be giving a second bag of 20u following at 125/hr.

[sample24]

We used to do the old 20u/1liter of LR. We now do a 1:1 ratio. We have 30u/500ml LR for induction/augmentation. When the placenta delivers, we bolus the remaining amount left in the original (hopefully) 500mls, then we run a second bag of the same mix at 63/hr.