D&C in OB triage

[CMCRN]

I work in a level III hospital, about 6,000 births a year. We have a separate OB triage unit 2 floors away from L&D. We are trying to develop a protocol for doing D&C s in the triage unit. Does anyone do this? If so, up until how many weeks? And do you also do D&C if a PP pt comes back in bleeding after discharge?

[klone, MSN, RN]

What kind of anesthesia is the pt given? I have never heard of a D&C done anywhere but in an OR. I personally would not want what is essentially a surgical procedure done in a nasty triage room.

[CMCRN]

Conscious sedation, usually fentanyl and maybe versed. I think all of us would prefer they be done in the OR also. It requires one of the triage nurses be one to one with that pt and is quite often is not as straight forward as it is billed by the OB. So I just wanted to get a sense from around the country what others were doing.

[klone, MSN, RN]

If she's on conscious sedation, doesn't she need to be monitored (EKG)? Do you have that capability in triage?

[CMCRN]

Our conscious sedation protocol does not call for EKG monitoring. We do q 5 min vs, bp,pulse and O2 sat. Usually it is just fentanyl which we also give to our labor patients.

Primarily it is for D&Cs that would have been done in the office except that it is afterhours, nights and weekends.

[CMCRN]

Oh and we have 24 hour in house anesthesia backup.