Cervidil placement

Published

Specializes in Mother/Baby;L/D.

HI all!!

What is the best technique for cervidil placement? I am a little scared to start placing them (the RNs do them at my hospital). I already know how to place IUPCs and FSEs, but cervidil scares me!! I know it goes behind the cervix in the posterior fornix, but HOW do you know it is in the right spot?? Does it just take practice..? Then when you slide your finger out, isnt it easy for the insert to be displaced?? any tips would be great! People have demonstrated to me how to do it, i just dont want to be responsible for placing it INCORRECTLY then some MD comes and chews my head off!! help help help :o

Up Vote Up Vote ×
Specializes in L&D.

Sorry, can't help you here. The physicans place the Cervadil here - as well as the IUPCs and FSEs.

Up Vote Up Vote ×
Specializes in nursery, L and D.

The nurses at my old hospital placed cervadil, but I never did, as we had gone pretty much to all cytotec. I had a cervadil induction with #2 10 years ago, and the nurse placed it. Guess this isn't all that helpful, lol.

Up Vote Up Vote ×
Specializes in NICU, High-Risk L&D, IBCLC.

Placing Cervidil has not been one of my stronger points either. The first few I placed promptly fell out in the toilet the first time my patient got up to the restroom.....I've gotten better at it since, but I still am never quite sure if it's in the absolute proper position or not. And it does tend to displace when you remove your fingers. I just do the best I can and take my time as long as patient is tolerating it OK. I think as long as it's somewhat close to the proper position, you'll be fine.

Up Vote Up Vote ×

We place them at my hospital. We also all place FSE's. Most of us also do IUPCs, but you have to be checked off on that first (I haven't yet). Anyway, with Cervidil, it's supposed to be placed behind the posterior fornix, but anywhere next to the cervix (not in) is fine. First I check the patient (with a different set of gloves) in order to find out where he cervix is, and if she actually needs Cervidil. Before placing, I always bend the Cervidil once to help release prostaglandin. The Cervidil is straight up and down as I start to place it (where I originally found cervix). Then, I turn it sideways, once I've found where I want it placed. After placement, I ALWAYS tuck the string in the lady parts. It is much harder to tuck the string in because the blasted thing tends to get stuck on your finger as you're trying to tuck it in. However, it is well worth it if you can because they rarely fall out this way. After this, I do one more SVE to check placement of the Cervidil, and instruct my patients to only pat dry when they use the restroom. I'm a newer nurse, so I've only placed about 30? Cervidils, but I've only had one fall out. Half of my Cervidils go into labor during the night with a lot of cervical change. The others tend to change minimally if at all. They usually all c/o cramping at about 0300, so I trust my placement. LOL!

Up Vote Up Vote ×
Specializes in all areas of ob-gyn nursing. er. pacu..

does anyone know what the alabama board of nursing says about rn's placing cervidil or cytotec for inductions?

thanks:)

Up Vote Up Vote ×
Specializes in Community, OB, Nursery.

Have you checked their website? That may point you in the right direction. :)

Up Vote Up Vote ×
Specializes in all areas of ob-gyn nursing. er. pacu..

yes, and i can't find anything. so i have an email into them.

thanks

Up Vote Up Vote ×
Specializes in Community, OB, Nursery.

Okey dokey. Just thought I'd ask. They are really your best bet. You may have to be persistent but it is worth it to hear it straight from the source.

Up Vote Up Vote ×
+ Join the Discussion