Do you check DTR when pt has epidural?

Specialties Ob/Gyn

Published

Do you check DTR when pt has epidural? clonus? homan's sign?

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Specializes in Trauma Surgical ICU.

OB is not my specialty but I have cared for a few in the ICU, I check DTR if the pt is on a mag and pit gtt. We did them q4h.

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Nope, never in the three places I've worked. Dermatomes & bromage for epidurals. DTRs for mag sulph patients :)

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What about mag pts with epidurals?

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Specializes in Public Health, L&D, NICU.

We checked if they were on mag, but I've never heard of doing it on a pt with an epidural. What would be the point?

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What about mag pts with epidurals?

Well yeah, of course :) but not because of the epi.

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Specializes in OB.

If the patient has an epidural you can check dtr's on the arms - tap at the inner aspect of the elbow and observe "twitch" at the thumb/hand.

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Specializes in Labor and Delivery, Medical, Oncology.

I always do, but only because I maintain an uptight and anxiety ridden attention to detail (not recommended). I expect 0 reflexes. However, the other day I had a patient who had had perfect BP's her whole pregnancy, but was in labor with an epidural in place for several hours and having BP's 160/90. When I checked her DTR's at her knees I got 2+ bilaterally. No other s/s of PIH, and after delivery her BP's started going down. Stress of delivery?? Who's knows.

Never thought of checking DTRs at the elbows, though. Thanks for the tip!

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