No Accels

[nurse79]

Just curious..there is an OB on our unit that loves to crank the pit.." q 20 minutes". Being a new RN, i'm always nervous about pumping it up. I know the OBs want them delivered..so how long is too long to not have any accels with minimal variability? With NO decels? Just curious..when do u update the MD, after 30 mins of no accels, or 1 hour with minimal variability

[SmilingBluEyes]

*blushing* thank you. I appreciate your kind words.

[jrring1019]

Position is so important! I find that this is often the most neglected part of the labor process especially when the pt has an epidural. It will very often speed up labor and improve strips. To answer the OP's question, before you call the doc for lack of accels or decreased ltv change her postion and even back off on the pit and see if you get a better tracing. I find that we crank the pit to q 2- 3 ctns and the pit gets a little too high and if you turn it back you still have a good pattern and an improved strip. If the ctns space out too much then you can go back up, but remember that that kid needs a break! If you have no accels and decreased btbv on pit and she is only 2 cm you have a LONG way to go and if you crank the pit it will only get worse.

I had a pt recently who was stuck at 5 cm all day (primip) on pit and looking at a c/s. I asked her how long she had been on her left and she said all day. I just turned her to her right and then sat her up and she was complete within an hour. Remember position is as important as pit!