Need info for circ presentation

onehusbandsevenkids · Dec 6, 2006

pretty please?

onehusbandsevenkids · Dec 7, 2006

RNmommy · Dec 7, 2006

I would estimate that 90% get circs where I am now. They all get anesthesia. Some docs use lidocaine others use EMLA. All the babies get Sweet-Ease. If the anesthesia is given time to work, it works fine. I've witnessed many babies go through their entire procedure without even flinching. We don't give post-circ meds, like tylenol or motrin. Once in a blue moon, a circ will bleed. That's the worst I've seen.

I hope your presentation is taking an anti-circ position :)

Elvish, BSN, DNP, RN, NP · Dec 7, 2006

I would say about 60-70% of our babies get circed here. Everybody uses a lidocaine nerve block at the base of the member. Everybody gets a loading dose of Tylenol about an hour beforehand and Sweetease afterward prn. That said, I still see a lot of babies screaming their head off as soon as the doc starts messing with them.

Fortunately we haven't seen a lot of circs go bad. Saw one bleed but not til the day after the circ and it was UGLY. Kid was fine but still no fun. I have also seen some circs that didn't have any complications per se, but looked like whoever did it decided to peel the skin off half the penile shaft too. OUCH!

Circs really need to stop. I hope your presentation is anti-circ also.

babycatcher2B · Dec 7, 2006

I've never been involved w/ circ, thank goodness, and we don't do them where I work now. We make referals for parents who do want to circ which is a very low percentage of our pts. Where I used to work the rate was higher- somewhere between 75-80%. Those babies didn't recieve any pain meds (I only know cause one of my friends worked in the L&D we transfered to). Tylenol was usually given post-op.

In RN school I made did a project on circ and it was heavily anti-circ. I was compelled to do it after what little effort I saw being made at informed consent. I eventually used the presentation and brochure in my childbirth classes. So add me to the list of RN's that think there needs to be an end to RIC!!

ps...have you done any research on Marilyn Milos and Nurses for the Rights of a Child?

allnurses Guide · Dec 7, 2006

90% of boys are circ'd here.

All the docs except one do lidocaine injection at the base of the member. The one doc does not do anything to prevent pain.

We do not treat afterwards for pain - the babies usually go home with their parents an hour after the circ is done.

I can personally remember only one with slight bleeding.

I use a pacifier during the procedure while the doc is working - we don't have "sweetease". Most babies don't cry.

I am anti-circ but all 3 of my boys are circ'd because of Dad . . .and the adult boys are glad and say they would be mad at me if I had won the argument. My youngest is 5 and has no idea . .

Why do you want anecdotal info for your report?

steph

mitchsmom · Dec 7, 2006

What % would you estimate of circs are done in your facility?

It is hard to say because many of them get it done outpatient (our medicaid doesn't pay for it, and it is cheaper outpatient (without added hospital costs). I would guess maybe 50-60% but I'm not sure. We have a lot of hispanics who don't do it, in addition to some others who don't. Then of course there are some who wouldn't consider anything BUT doing it.

What % get any type of anesthesia? maybe about 50%

What is it? one doc does the lido injection/nerve block which seems to be better than the ones who do EMLA, but I have yet to notice one of the babies who wasn't screaming (but maybe I didn't notice for that exact reason...although it is done on the far side of our nursery so it's usually readily apparent for the nurses when one is being done...). We don't have sweet-ease.

Do you feel it is effective enough for the pain of the circ? no

Do babies get after circ pain meds? I don't think so; the pts I've cared for didn't.

How often do you see problems with circs? I have been at my hospital since July and I've seen one that kept bleeding for some time (it seemed like the doc was there and hour or two fixing it and making sure it was ok). I have heard about a couple of other nightmare ones there, before my time (like too much taken off - not like the member itself but way too much; also bleeding too much).

Anything else you'd like to add? I personally didn't circ my three boys so you can guess where I stand when asked... :) I can't stand to hear it when one is being done and I try to go away if I don't have to be there.

Mimi2RN, ASN, RN · Dec 7, 2006

We have one doc does circs at the hospital, maybe average 2 a week

all others are done at the ped's office. We average 350 deliveries a month, but I have no idea how many get circed.

"We don't have Sweet-ease." Try mixing 1 packet of sugar in 10mls sterile water. Or 5 packets in 50mls in a volufeed, and refrigerate it. Give it with a little syringe. The babies will be much happier. We have done this for years, use it for blood draws and IV starts, too.

allnurses Guide · Dec 7, 2006

We have one doc does circs at the hospital, maybe average 2 a week
all others are done at the ped's office. We average 350 deliveries a month, but I have no idea how many get circed.
"We don't have Sweet-ease." Try mixing 1 packet of sugar in 10mls sterile water. Or 5 packets in 50mls in a volufeed, and refrigerate it. Give it with a little syringe. The babies will be much happier. We have done this for years, use it for blood draws and IV starts, too.

Hi Mimi!

We do have glucose water . .. . is that "sweetease"? :confused:

I have to say that most of the babies do not cry, just with a pacifier. Which I'm grateful for. I usually try to have a conversation with the doc to keep my mind off what he is doing. We live in a small town - we talk about our kids or something.

steph

Elvish, BSN, DNP, RN, NP · Dec 8, 2006

Also, you may want to read Barbara Harper's book Gentle Birth Choices; it has a very informative section on circs in a chapter on dispelling medical myths surrounding birth. Good luck!