Do you always keep emergency meds on hand for deliveries?

[perfexion, ASN, RN]

I have a colleague who brings cytotec, hemabate AND methergine to every single delivery. I understand wanting to be prepared but I think that's a bit much. Don't get me wrong. If I get a G12 or a 2nd day induction patient I'll probably bring all that stuff to a delivery too, or at the very least, some IM pitocin. Do you bring emergency drugs to every single delivery?

[dariah]

No. Case by case like you said.

[winter_green]

Yes. It's standard at our hospital we have emergency medications at every delivery. You never know when you really need them, always good to have them. And if you don't need it, you can always return them.

[klone, MSN, RN]

Cytotec and Methergine, yes. Every delivery. I also set up the warmer with a shoulder roll for the baby, in case of NRP, every delivery.

[Elvish, BSN, DNP, RN, NP]

Cytotec, yes. Methergine and Hemabate, no.

I'm baby nurse at deliveries....I have my little system of blanket setup, but will now incorporate a shoulder roll. Thanks, klone!

[cayenne06, MSN, CNM]

Pitocin is on hand at every birth. Cytotec is easy enough to keep on hand too, but I don't and neither do any of the providers I work with. But methergine? And HEMABATE? Hemabate is hella expensive and not shelf stable. I wouldn't keep that on hand unless I had a patient at high risk for PPH who couldn't take cytotec or methergine for whatever reason, or if they had had a past PPH that did not respond to those first line agents.

[Calinurse4]

We bolus every patient with pitocin following delivery. If they are at any increased risk for PPH, we will usually have either Hemabate or Methergine at the bedside.

[klone, MSN, RN]

Not only is Hemabate expensive and not shelf stable, but you generally also give it with Lomotil, and I believe that's considered controlled. Also, Hemabate shouldn't be given if the patient has asthma, and so many of our patients do that I wouldn't automatically keep it on hand.

[Calinurse4]

That's true, no Hemabate for asthma patients and no Methergine for hypertension. That's one of the first things I learned when I started as a new grad last in l&d last year. Luckily, I have only had to use them a handful of times in the past year.

[seemerun]

We always keep at the bedside throughout the labor and delivery - 800mcg cytotec, 500cc of pitocin, terbutaline and lidocaine.

[k-t-did]

We have "delivery kits" which are locked plastic boxes with 800 mcg of cytotec, a vial of lidocaine, some methergine, and extra pit. They are taken to every delivery. Hemabate has to be refrigerated. It also would be given AFTER the other drugs were already tried and failed, in my experience....so I wouldn't keep that bedside. Someone could go grab it if you think things are deteriorating to the point of needing it.

I find that people who have strange, over the top habits like that, have lived through a bad scene....and that makes them feel safer.

[eylee08]

We have emergency meds for every labor pt in the room. Pit (IM and IV), miso, and lido (not emergent but for convenience I guess)