Acoustic Stimulator

SmilingBluEyes · Nov 13, 2003

WE dont' use them........

if the baby is not reactive after feeding/hydrating/repositioning mom, she gets a BIOPHYSICAL ...period.

OBNurseShelley · Nov 13, 2003

I've rarely used them, I don't believe in them, I think it's cruel and unusual punishment and I've seen occasionally the baby decel after doing it. If she was in active labor then scalp stim might have been more appropriate, if you dont get an accel with scalp stim, then maybe something IS giong on, especially if like you say all day long there NO accels, and no response with other measures, that is a non-reassuring tracing and follow-up needs to be done.

trogdor · Nov 13, 2003

We use them in triage if there are no accels, but never in labor. We try hydration, scalp stim, and O2.

SmilingBluEyes · Nov 13, 2003

I believe I read a study that really concluded this was not useful practice...can't remember where----------

I think if the baby looks bad on strip, "shocking" or "startling" him/her won't be the answer.....

You need to investigate and this measure wont' provide any answers unlike a BPP would.

and where I work, scalp stim is never used in the case of decels where we work...only if a strip is flat and *absent* decels. Heard at an AWHONN conference that scalp stim on a stressed baby makes things WORSE....I can see why.

OBNurseShelley · Nov 13, 2003

I agree about not using scalp stim with dcels, heard the same thing at an AWHONN conference. BUT, how many times have I seen the doctor doing scalp stim????

imenid37 · Nov 13, 2003

Never used acoustic stim during labour. To get a reactive NST we have used nurse-generated acoustic stim (banging plastic bedpans together or loud clap near mom's lower abd rather than zapping the poor kid w/ the buzzer). Often this is just as effective as buzzer. Trying to use scalp stim during decels (drs do it ALL the time) to bring them up is not supposed to be effective and can cause the decel to worsen, I think due to vagal stim. Not sure if I heard this from a Michelle Murray seminar or maybe Judy Poole. Sorry the brain is failing me today!

dawngloves, BSN, RN · Nov 13, 2003

Originally posted by imenid37
To get a reactive NST we have used nurse-generated acoustic stim (banging plastic bedpans together !

Trying to picture scene :chuckle Hey, whatever works!

Browneyedgirl · Nov 13, 2003

If the strip is not showing accels or decels of the fetal heart, do you use a fetoscope and try to listen for the heartbeat that way?

Just wondering?

SmilingBluEyes · Nov 13, 2003

no.

we get a BPP.

dont even have fetoscopes around.

BETSRN · Nov 16, 2003

We have been taught not to use accoustic stim. Why would someone let a patient go with an unreassuring strip for that long without hydration, position changes, etc.? Then one should have a biophysical profile.

acuteobrn · Nov 16, 2003

We don't even own a accustic stim. I agree, hand clapping, reposition and hydration do the trick, if not....BPP. Haven't seen them do one in labor though, just for NST, as we don't have a US tech in house...smaller city hospital, not alot of funds.

Anyhow, I know there is a big debate on the usefulness of D5LR, I agree with not giving a bolus and never hanging on toward delivery, I have seen it work in early labor, piggybacked. What do you all think?