Narcan?

[mitchsmom]

Just curious, do you have Narcan out when each baby is born (like in the isolette with your vitamin K and stuff)?

One place I was out kept it right there with other baby drugs each time, the other kept it in the med room.

[dawngloves, BSN, RN]

**edited because I sounded kinda fresh before**

I've only given Narcan to a newborn once. Unless you use opiates on a regular basis and don't have ready access to the Narcan, what the heck!

[SmilingBluEyes]

Narcan is used judiciously and carefully and if a kid needs it, by policy, we have to observe him/her in our special care nursery for a minimum of 6 hours on monitors.

I have only given Narcan a handful of times in my OB career. With the increase in epidural use, it's become less common, from what I can see-----fewer IV narcs being used for pain control is the main reason.

[Gompers, BSN, RN]

Narcan is used judiciously and carefully and if a kid needs it, by policy, we have to observe him/her in our special care nursery for a minimum of 6 hours on monitors.

I have only given Narcan a handful of times in my OB career. With the increase in epidural use, it's become less common, from what I can see-----fewer IV narcs being used for pain control is the main reason.

We rarely give it as well. Agree that many more moms have epidurals instead of IV narcotics so it usually isn't necessary. We also have a large population of drug-addicted moms - some of them undiagnosed prior to delivery - so we hesitate to give it to any baby without first having the mom's tox screen results.

[SmilingBluEyes]

Exactly another good reason to withhold NARCAN if you are unclear to history. I have been known to ask and then tell moms, 'look there are meds we give some babies who are slow to breathe that in some cases can make your baby WORSE if we don't know what we are dealing with here"----

I am not the moral police, but we have to know before we give it, clearly.

[Gompers, BSN, RN]

Exactly another good reason to withhold NARCAN if you are unclear to history. I have been known to ask and then tell moms, 'look there are meds we give some babies who are slow to breathe that in some cases can make your baby WORSE if we don't know what we are dealing with here"----

I am not the moral police, but we have to know before we give it, clearly.

Yep, yep, yep.

This is why we very very very rarely give it in the delivery room. If the mom's admission tox screen is negative and we know she had narcs in labor, of course we'll give it. But usually we don't know about mom yet. So we will actally consider it to be respiratory distress, intubate the baby, take it up to the NICU, and await both mom and baby's urine tox screens before administering the med. I once saw a baby have horrific seizures after being given Narcan without the docs knowing about mom's secret drug history.

[mitchsmom]

Thanks for the feedback. I was wondering...

The place that kept it on hand must have had some kind of bad experience/precident or something. (????)

[SmilingBluEyes]

We keep it on hand, to be sure. But we don't draw it up w/each delivery......anymore, like I said, rarely.

[mitchsmom]

Right, right... but I mean on hand as in right there with the vit k & eryth. ointment (as a matter of fact, that might be a worse idea... I heard that a student/instructor team had some confusion and almost gave the Narcan instead of the vit. k recently).

Or maybe they give a lot of narcs to mom (though I didn't notice it).

Anyway, thanks again :)

[RNnL&D]

Right, right... but I mean on hand as in right there with the vit k & eryth. ointment (as a matter of fact, that might be a worse idea... I heard that a student/instructor team had some confusion and almost gave the Narcan instead of the vit. k recently).

Or maybe they give a lot of narcs to mom (though I didn't notice it).

Anyway, thanks again :)

Nope, we never have it on hand for delivery. It's kept in the Pyxis. In my three years in OB, I have never seen it used.