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Discussion

Delivery Pitocin

What does everybody do for delivery Pitocin after the placenta? We use Pit30units/NS500ml for inductions, but after delivery we change out to Pit 20units/1L LR at bolus rate. I have recently heard that other facility close to us boluses their Pit30units/NS500ml after delivery, our pharmacists disagree with this saying that the concentration is too much.

Thanks!

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Our induction pit is the same concentration (10units/500 ml) as our post partum pit (20units/1L), but we still d/c the induction pit after delivery and only run the post partum pit - and we don't bolus it anymore unless a doctor specifies orders different from our unit standard which is 250 ml/hr x 2 hours, then 125 ml/hr x 4 hours.

We use 30 units pit in 500 ml NS wide open at delivery of the placenta (pharmacy mixes, this is the same bag we use for labor, just pull the tubing out of the pump, if it has been running through labor we run the remainder of the bag). Then we hang another bag of the same at slow to mod rate to send them to the floor with. To me, that seems like a whole ton of pit (and fluids).

At homebirths we never used proph pit postpartum unless there were risk factors, and then 10 units IM.

We do what Ischialspines described except they generally just get the one 500ml bag.

We use the 30 units Oxytocin in 500 mls for induction, then run at 125 ml/hr after delivery. Where I used to work we ran it at 444 ml/hr after delivery, why that rate, I don't know :)

We use 20units in 1l, bolused immediately following birth and then set to 125ml/hr x 1 additional bag.

We do what Ischialspines described except they generally just get the one 500ml bag.

ditto. We just run in the remaining bag (30u in 500ml) after delivery.

We bolus the 30ml in 500cc.

we run the 30/500. I have run much higher concentrations per physician order in cases of PPH. its all madness.

We also utilize the 30 U Pitocin/500cc LR for inductions. After delivery the remainder of the solution is ran in @ 250cc/hr. Sometimes the patient may receive an additional bag of 1 liter LR with 10U Pitocin based on bleeding. We do have one physician that additionally injects 20U Pitocin in 20cc LR into the umbilical vein after the cord is cut.

We also use the 30 of pit in 500 for induction/augmentation, and we just use this for after delivery also. If the pt. hasn't been on pit, then we use a bag of the 20 of pit in a 1000. It's really a nursing judgement where I work as to how much they actually get from the bag. I tend not to give the whole thing unless there is an issue.

We use 20 units pitocin in 1000 cc LR. That is standard, for everyone. That is used for induction/augmentation during labor, then as a bolus after placenta for 3rd stage management. If no risk factors for PPH, I usually titrate it down after the 2nd fundal check, and cap off the IV before the whole back is infused (by one hour postpartum). If increased risk for PPH, or having heavy PP bleeding with fundal checks, I run it in bolus, and if still at increased risk after that first bag, usually add another bag at 125cc/hr. It all depends on the individual patient and risk factors for bleeding.

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