IUPC and Fetal Spiral Electrode Placement

jenrninmi, MSN, RN · Sep 21, 2007

Where I work, the physician places those, not the RN.

dawngloves, BSN, RN · Sep 21, 2007

Can I highjack and ask how to get the scalp clip off?? The docs and I always putz around with it until the OB nurse helps us out. :uhoh21:

babyktchr, BSN, RN · Sep 21, 2007

Although I teach both placements in the AWHOHNN intermediate course, our scope of practice in my state does not allow us to do it. Only docs and midwives. Turn the scalp clip counterclockwise to get it off. Sometimes they get stuck if the baby has a ton of hair, or if the practitioner turned it more than 1 1/2 times into the scalp.

cassioo, RN · Sep 22, 2007

We only place scalp lead if you've been to AWHONN course and you've put them on under supervison of MD we don't put in IUPC. To get them off turn as answered above. You aren't suppossed to pull the wires apart but I've been known to do that sometimes.

LizzyL&DRN · Sep 23, 2007

We place both FSEs and IUPCs where I work. For the FSE,

#1 Always make sure you are not placing the FSE on a suture line or fontanel.

#2 Make sure you are placing it on a Head! Although i have seen is placed on the heel of a footling breech twin, I couldn't monitor the baby due to position, so the MD placed it on the baby's foot. Worked great too!

#3 Don't place an FSE on a GBS positive mom unless you absolutely have too. Also, if you aren't sure of mom's Hepatitis status or HIV status, don't place one.

#4 Don't forget to remove the FSE if mom goes for C section before the surgery starts. you will get a bigtime chewing out by MD for ruining his sterile field if baby comes out with FSE still attached.

FOR IUPC:

#1- Make sure mom is in fact ruptured.

#2- Don't push if you meet resistance, don't want to sheer off a placenta.

#3- Don't forget to zero it out.

#4- If you are amnio infusing, make sure you check for returns on the chux pad, if not, you may see the resting tone start to increase.

General:

#1 These are invasive procedures, only due them if they are medically necessary. I don't like hearing that nurses are putting them in for convenience sake of the nurse. That is not a good reason for an invasive procedure.

#2- Don't get discouraged if you can't get either one in, sometimes seasoned nurses have trouble.

I'm sure there are more that I can't think of right now. Maybe someone else will have more to add. Good luck.

nurse79 · Sep 23, 2007

thanks LizzyL...that totally helps. I did an IUPC the other day with another RN shadowing me. Just anxious about the FSE!! But your advice is great also

joeb1, ASN, BSN, RN · Oct 9, 2007

don't worry, i think iupc's are harder than spiral electrodes to place. we do both here, and i feel fairly comfortable placing both, but the thought of placental injury with an iupc does stay in my mind.......

Mrs.S · Oct 10, 2007

We only place scalp lead if you've been to AWHONN course and you've put them on under supervison of MD we don't put in IUPC. To get them off turn as answered above. You aren't suppossed to pull the wires apart but I've been known to do that sometimes.

why aren't you supposed to pull the wires apart?