Ephedrine

[Bonnierose]

This is a practice issue

On post partum patients who have had an epidural are RNs able to give ephedrine IVP for hypotension? Please let me know the your practice

Pharmacy says we should but OB nurses do not want to do it. I just think they need education so they will feel more comfortable with the practice. Please also let me know the state you live in. Thanks

[strn96]

The staff RNs at my hospital are allowed to give ephedrine IVP, but the CRNAs have to stick around for at least 30 min p epidural placement so they're usually still there to give it if needed. I have ended up giving it myself a few times with great results. In the case where pt's BP bottoms quickly and CRNA already left, I'm glad we don't have to wait for them to come back to give ephedrine, esp when BP is so low baby is decelling. I agree that IVF bolus usually does the trick, but I've had a few pts that are still severely hypotensive after 2 liter bolus (1 liter bolus a epidural and 500-1000ml bolus p epidural if hypotensive).

[crysobrn]

It's part of our epidural orders. Our CRNA or MD will give it if in the room but it stays at the bedside and then we give it if needed. I've only used it once myself as the CRNA is usually still there when needed.