02 sat and duramorph

  1. How often do you check a pts 02 sat postpartum that had duramorph during a c/s? one hospital i worked at checked it continuously while the pt was in PACU but once d/c'd to postpartum you only check it if pt appears to have resp distress. another hospital i worked at has the pt on continuous pulse ox for 12 hours postpartum. Also, does your pt. have to be on a continuous pulse ox while on a PCA? All this 02 sat crap seems overdone if the pt is satting 99-100% RA for 2 hours straight and no signs of resp problems.
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  2. 9 Comments

  3. by   NurseNora
    In my hospital, anesthesia standing orders call for O2 sat and respiration to be done hourly for 24 hours. After spinal or epidural narcotics, the patient is at risk for respiratory depression for this time period. You will see lowered sats and decreased respirations before you get changes in the patient's sensorium. A lot of our patients need O2 to keep their sats up, especially when they fall asleep. But then I'm at 6500 ft where there's not enough O2 in the air anyway.
  4. by   BabyRN2Be
    I don't know about all hospital P&P, but according to rxlist for Duramorph, the patient should be monitored for at least 24 hours after the last dose.

    http://www.rxlist.com/cgi/generic/duramorph_ids.htm

    PATIENT MONITORING SHOULD BE CONTINUED FOR AT LEAST 24 HOURS AFTER EACH DOSE, SINCE DELAYED RESPIRATORY DEPRESSION MAY OCCUR.


  5. by   BookwormRN
    On our m/s floor and on OB, pts are on continuous pulse ox for 24 hours post duramorph.
  6. by   jenrninmi
    Quote from NurseNora
    In my hospital, anesthesia standing orders call for O2 sat and respiration to be done hourly for 24 hours.
    That's how it is at the hospital I'm at too.
  7. by   RNLaborNurse4U
    We do continuous pO2 monitoring while in PACU (30-45 minutes), and then Q1 hr resp rates for 24 hrs on postpartum. No pO2 unless s/s resp distress.
  8. by   aander2
    Quote from lmc512
    How often do you check a pts 02 sat postpartum that had duramorph during a c/s? one hospital i worked at checked it continuously while the pt was in PACU but once d/c'd to postpartum you only check it if pt appears to have resp distress. another hospital i worked at has the pt on continuous pulse ox for 12 hours postpartum. Also, does your pt. have to be on a continuous pulse ox while on a PCA? All this 02 sat crap seems overdone if the pt is satting 99-100% RA for 2 hours straight and no signs of resp problems.
    The hospital that I work at requires continuous oximetry for 24 hours following administration of duramorph and hourly resperations. Pt's who are on PCA's ie Morphine or Dilaudid are not required to be on cont ox. Worth mentioning, narcotics are not to be given to Pts given duramorph for 24 hours unless with approval by anesthesia where I work. Is this the general rule out there? Thanks.
  9. by   BirthCenterRN
    We do continuous o2 sats for 24 hour. 1/2 respirs for 12 and then hourly for the next 12. They do not get Narcotics post duramorph unless we get and order. It is very annoying when you have 2-3 post c/s and are running around check sats but I realize the importance.
  10. by   SmilingBluEyes
    Our patients are on continuous SAT monitoring x24 hours when they receive duramorph spinals.
  11. by   Mrs.S
    Quote from BirthCenterRN
    We do continuous o2 sats for 24 hour. 1/2 respirs for 12 and then hourly for the next 12. They do not get Narcotics post duramorph unless we get and order. It is very annoying when you have 2-3 post c/s and are running around check sats but I realize the importance.
    that's exactly how it goes at my hosp too

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