epidurals

[chloe]

At the facility I work at currently, we are required to program our own epidural pumps. Some docs even tell us to connect them to the patient without even checking the settings. The only policy that I have found at my facility states the md must connect the tubing to the patient. It says nothing about the programming of the pump. I was wondering if other facilities had different policies re:epidural pumps.

[sharann, BSN, RN]

We program the pumps as ordered, but the M.D (or CRNA if you have them) MUST connect the system. This is so they assume responsibity that the catheter is in the Epidural space (rather than a cath that may have migrated to vasculature or other places).

[kyti]

We program the pumps and connect them to the patient, but only after Dr has verified placement.

[Fgr8Out]

Our facility has implemented an annual competency program which includes care and maintenance of epidural catheters. Depending upon anesthesia orders, we can attach and set up a pump for continuous infusion, or administer a bolus of the specified medication (generally preservative free morphine of fentanyl). We are taught how to check for proper placement or the catheter and our policy defines the parameters for which we are to report to the anesthesiologist when we run into any inconsistencies. The anesthesiologist rounds daily on the patient and does a check of their own as well. In addition, so long as an epidural catheter has been in place no more than 72 hours, RNs may remove them when ordered by the anesthesiologist.