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dawngloves dawngloves (New Member) New Member

Meconium deliveries

Ob/Gyn   (8,515 Views 22 Comments)
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What is your protocall for mec deliveries? Who attends?

I have a hair up my butt after a busy day of running to thick, thin, terminal mec deliveries all day! I go with a resident, maybe two and as I'm standing there I wonder what do they do in hospitals with no NICU? I mean 99% of the time it is OK, thank goodness. But I'm a little peeved that I have to drop everything to run and pretty much hand a doctor a mec trap.

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in our little place (600 deliveries/yr.), we would only call for ped (who comes from his/her home or office) if the mec was really thick or there was a horrendous fh pattern if it was going to be svd. our peds (and a few family dr's. come to all c/s deliveries). mostly it's o.k. and we don't need anyone but the two nurses and the ob to handle most mec deliveries. when we do call for peds they haul their behinds in like lightening because they know we REALLY need them.

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I AM FROM A HOSPITAL THAT ONLY DOES ABOUT 40-60 DELIVERIES A MONTH. WE HAVE ANESTHESIA VIEW CORDS FOR MEC DELIVERIES. WE ONLY CALL THE PEDS IN IF A PROBLEM DEVELOPS OR SOMETHING OMINOUS BEFORE DELIVERY THAT WE SEE OR FOR PREMIE. WE HAVE ANESTHESIA VIEW AND DELEE CORDS. AND THE 2 L&D NURSES. IT SEEMS TO WORK WELL FOR US, UNLESS THE PT DOESN'T HAVE AN EPIDURAL THEN ANESTHESIA ISN'T AROUND, THEN SOME OF OUR OB WILL VIEW CORDS AS WELL.

WOULD LIKE TO SAY HELLO TO EVERYONE I AM NEW TO ALLNURSES AND I REALLY LIKE IT A LOT. HOPE TO BE TALKING WITH YOU MORE OFTEN

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Glad to have you with us, you will find there are a great bunch of people here.

I just wanted to mention that typing in all caps *usually* indicates yelling.

So...tell us a little more about yourself :)

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We have about 10-20 deliveries a month. On the rare occasion that we have mec, if it's thin and no fetal stress indicated on the strip, then we just call RT to come down "just in case" but the doc delee's on the perineum. If it's thick, or fetal stress is indicated, then we usually try to get the ped to come in, in addition to RT. We don't have a nicu.

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We have 350-400 deliveries a month, and are called by the labor nurse to attend mec deliveries, with our hospitalist(an in-house ped 24/7). We try to delee on the perineum, and get the baby transferred to the warmer asap, to visualize and suction below the cords. If it's thin mec, we sometimes let the docs sleep on nights, and call if necessary.

I am amazed how many mec deliveries we have, sometimes several in a day. Usually no problems, but when it's bad, it's very very bad.

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Sorry, don't mean to yell.:) I work in Labor and Delivery, I am an RN and absolutely love it except I work nights, I am really tired of nights, but oh well, have to do what I have to do cause I can't imagine working in any other dept. Yea when mec is bad it is really bad, had one a few weeks ago, mec aspiration, ended up on ecmo, yuck, doing ok I believe now though, thank heavens.

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hi from another night nurse! i love my job too, but not always the hours that i work.

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We do about 20 deliveries a month, no NICU. We only call peds if the mec is moderate or thick or if there is fetal distress. The OB delees on the perineum, and we do all have NRP. The new NRP standards say not to visualize the cords if the baby is vigorous anyway, so we don't do anything special except delee on the perineum 99% of the time since they changed this recommendation.

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a peds team attends all high risk deliveries. the team is made up of a NNP, or peds resident, and either a NICU RN or a mother baby RN dependent on the situation. there is a list of deliveries that this team must attend, including all mec deliveries. others are all c sections, 36 wk or less gestations, any time a physician requests, vaccum or forcep deliveries, non reassuring fetal heart tracings... etc. all of the l&d nurses are NRP certified, but for the most part never need to use it because the peds team is already there for the high risk situations. we do about 4,000 deliveries a year. the team is really helpful!

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Hopefully this isn't a stupid question, and it could pertain to mec deliveries.. Is anyone doing amnioinfusions anymore, and if so in what situations?? Thanks for any info. RMH

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