How many vac "pop-offs" for c-section?

  1. Okay, so I know w/ a vag delivery in a vac assist, the doc is only supposed to "pop-off" 3 times. What about a c-section? I had never encountered this before, but obviously the doc didn't make the incision large enough and he popped off 5++ times. I say 5++ because I honestly don't know how many, after the 3rd or 4th time I saw the cord hanging out of the incision and delivery was taking so long I knew the baby was going to be very depressed at birth so we were opening everything we needed. She was depressed: her Apgars 3/7/9. Anyway, during all these popoffs blood was flying everywhere, it was a horrible c section. Finally the doc decided to make the incision bigger like he should have done to begin with and was able to deliver the head. Anyway, of course I documented, documented and documented but I was just wondering if there is any policies in place for pop offs in c-sections. I'm thinking probably not but would like your input.
    •  
  2. 10 Comments

  3. by   dawngloves
    Sorry, I don't know our OB policies on that. But I just wanted to say how much I hate when the vacuum pops off! I have to turn around so no one seems my big, "ARGGGHHH!!!" face!
    But even worse are the too small incisions on a breech C/S! I am masked, so you can't see my big, "ARRRGHHHH!!!' face, but I will grab the nearest person I am so nervous! My heart can't take it!
    That's for the opportunity to vent.
  4. by   ragingmomster
    Three is the max, doesn't matter what type of delivery.

    Had a resident tell me last week that she could apply the vacuum as many times as needed as long as descent was occuring. I don't think so.

    We are being asked to use the Ask Assist Assert methodology lately.

    "Gee, Dr So-and-So, I didn't think we could apply vacuum more than 3 times?"

    "Gee Dr So-and-So, perhaps a slightly larger incision would help?"

    "Dr So-and-So, I will need to call for my nurse manager if you apply the vacuum again, because I cannot continue to document occurences outside of our protocols."

    It works with our residents, and they are the ones who need it the most.

    I would love to see ACOG or AWHONN standards added to this post by one of our SuperMods, hint, hint.
  5. by   nrse4evr
    i would think that 'pop-offs' for a section would be the same for a vag. 3. I wonder what it is with OBs doing a c/s and insist on making the hole too small. It there some sort of competition going[FONT="Comic Sans MS"] on that I am unaware of? All our residents make the incision at least 2-3 inches too small even for breeches, op's, or LGA kids. Then they struggle and struggle and usually end up with having to have the attending deliver the kid. I'm amazed that they make the same mistake over and over again.
  6. by   nrse4evr
    What is the Ask, Assist ect methodology. where can i go to get info on this. in my practice working with residents that soulnd likea far better way to go than our current "What in the ---- do you think you're doing?"
  7. by   prmenrs
    "...."Gee, Dr So-and-So, I didn't think we could apply vacuum more than 3 times?"

    "Gee Dr So-and-So, perhaps a slightly larger incision would help?"

    "Dr So-and-So, I will need to call for my nurse manager if you apply the vacuum again, because I cannot continue to document occurences outside of our protocols."..."


    I'm just trying to visualize saying those lines to one of the private practice OBs where I work. Yikes!! Fortunately, they don't do that many assisted deliveries.

    I googled ACOG standards: http://jeffline.jefferson.edu/SML/JE...ards/acog.html
    Last edit by prmenrs on Jan 22, '07
  8. by   ElvishDNP
    We had one kid that was VE'd (not with a c/s, but still) for 40 minutes. I mean 40 minutes of time the VE was actively suctioning the baby's head. I was so furious. Her head looked like ground hamburger, and I am not saying that to be irreverent, I mean that was exactly what it looked like. I was ready to spit nails. Grrrr. Thanks for the venting space.
  9. by   dawngloves
    Quote from prmenrs
    I'm just trying to visualize saying those lines to one of the private practice OBs where I work. Yikes!! Fortunately, they don't do that many assisted deliveries.

    I googled ACOG standards: http://jeffline.jefferson.edu/SML/JE...ards/acog.html
    We had one scream at us because we told her not to suction a mec delivery at the peritineum. The NM had to take her a copy of the new NRP guidlines. Ya think she said, "Sorry."?
  10. by   ElvishDNP
    Quote from dawngloves
    We had one scream at us because we told her not to suction a mec delivery at the peritineum. The NM had to take her a copy of the new NRP guidlines. Ya think she said, "Sorry."?
    Now, why would the almighty, all-knowing MD ever need to apologize for anything?? Ok, back on topic....
  11. by   Batman24
    What is a pop-off?! I am not yet in nursing school and I have never heard of this. Thanks.
  12. by   kirsnikity
    A pop-off is when the vacuum extractor is placed on the baby's head, suction is applied, and then it "pops off." The point of using the vacuum is to help guide the baby's head down when mom is pushing. At my facility we're allowed three pop-offs for vag and c/s deliveries.

    Nikki

close