[JB0901]

Hi everyone, new member here. I am a nurse in postpartum and am curious about something. Our unit used to give our moms rice socks that they could heat up in the microwave to help with cramping, and also incisional pain; however, JCAHO and risk management made us get rid of those. We now have these disposable warm packs, but they barely get warm and only last for about an hour. Our patients have really not liked them so far and we go through them so fast. What do other places use?

Also, just curious about what you use for ice packs for perineal swelling right after delivery? (We literally put ice in a plastic bag).

Thanks for the info!

[KYCNM]

At a hospital where I take students, L & D has a blanket warmer. We use warm blankets for the abdomen for cramping. I know it seems extravagant laundry wise, but most mom's don't need a warm blanket 24/7, and the blankets stay warm for at least an hour when placed under the covers next to the skin. We also use ibuprofen in 600-800 mgm doses for cramping. Some caregivers prescribe the ibuprofen prn, others order it every 6 or every 8 hours around the clock.

For ice bags for perineum, we fill a glove with ice, knot the end of the glove and cover it with a washcloth before placing next to the skin. The ice melts in about 20 minutes which is the amount of time recommended for ice to be used for pain relief. Again ice is only the first 24 hours, and not for constant use.

Hope this helps. . .These are things we did when I was in practice as a nurse midwife, too.

We also used the rice sock (this was in the early 90's) for back pain in labor and cramping postpartum. Moms brought the item with them from home (childbirth educators had it on their "things to take to the hospital" checklist). I understand how JACHO could be concerned about this practice, though. Is the microwave disinfected between warmings? (C-section moms might be at greater risk for incisional infection if not.) There is always the potential for people to get burned by the item.

As an after thought, I have a bedsock that I use for shoulder and back pain. I purchased it back in the 90's. It's filled with silicone and works great and I know it's about 15 years old.

Sorry for the long post. . .just random thoughts of an old nurse...

[JaneyW]

I have been at hospitals that have fancy ice packs in peri-pads and others that had nothing. My favorite is to put ice in the newborn diapers. Kind of a home-made peri pad ice pack.

[rn4babies63]

At our hospital we put water in the newborn diapers and freeze them. Works wonders on the perineum. We also use "k-pads" for heat. It is a water filled machine with a heating pad type attachment that the temp is set by central and not allowed to be changed. Most patients like it very much.

[Nicky30]

We have a few things we can use.

We use the gel hot/cold packs (not for peri pads). Of course they need replacing occasionally but that is usually because they walk out the door with the patients.

Expired saline bags (1000mls) get placed in the blanket warmer and can get used for hot packs (they are marked so they don't get used for IV).

We make our own ice peri packs out of frozen condoms and place them inside pads.

Nic.

[cherokeesummer]

Our unit has the peri pad ice packs that you twist and activate. They only last about 30 mins but the moms like them. They do not absorb blood well so it makes the bleeding look worse sometimes.

We have the warm packs too, that are just like what you are talking about and I don't think they stay warm for very long but nobody has complained. I have heard that we have k-pads but I've not ever used one.

[cmonkey]

I used frozen maxi pads and they were fabulous. Toss a couple glugs of witch hazel on that bad boy and life is good.

[jenrninmi]

'At a hospital where I take students, L & D has a blanket warmer. We use warm blankets for the abdomen for cramping. I know it seems extravagant laundry wise, but most mom's don't need a warm blanket 24/7, and the blankets stay warm for at least an hour when placed under the covers next to the skin. We also use ibuprofen in 600-800 mgm doses for cramping. Some caregivers prescribe the ibuprofen prn, others order it every 6 or every 8 hours around the clock.

For ice bags for perineum, we fill a glove with ice, knot the end of the glove and cover it with a washcloth before placing next to the skin. The ice melts in about 20 minutes which is the amount of time recommended for ice to be used for pain relief. Again ice is only the first 24 hours, and not for constant use."

These are the things we do where I work too.

[Elvish]

We have standing 'round-the-clock Motrin for SVDs and prn Percocet/Darvocet ordered.

For perineal pain, I like ice diapers - take a diaper, rip the top open & stick it under the ice machine, though I imagine water & freezing would be essentially the same thing. I don't like putting washcloths (over gloves) down there because our washcloths are really rough. This for the first 24 hours. Plus the usual dermoplast & witch hazel pads.

If mom wants something warm afterward, we can do sitz baths. My sitz bath was my best friend for about 2 weeks postpartum and a 2nd degree lac.

Our hospital recently 'outlawed' microwaved hot packs, mostly because there is no way to ensure a temperature that won't cause a burn like you can w/ a blanket warmer.

[AZMOMO2]

When I had my baby they had peri-pads that were twist activated for cold. The L & D I did my clinical at this weekend uses frozen filled condoms and the RN I was working with had not heard of the twist cold peri-pads. Weird and ironic I thought. ( the condom part ) lol