Joined: Nov '01; Posts: 1,487; Likes: 70
Geez, Tiffany!! You're posting like a madwoman today!! :chuckle
Yes, I've had pts. who couldn't have epidurals. They had extremely low platelet counts (platelets are what enable your blood to clot), and it is dangerous to give a pt. with a low platelet count an epidural.
One other instance I can think of is a pt. who was a hemophiliac. She couldn't have an epidural for obvious reasons.
I've taken care of patients who've had head injuries, back injuries, rods in their backs, scoliosis, even a paraplegic pt. (who swore she could feel everything), and they were all able to have epidurals.
:chuckle Shay, thanks for replying to all my posts! Actually I just made my 'rounds' and called all my doula clients, and these were some of their questions... and talking to them sparked questions of my own. What better place to ask then on a forum full of OB nurses! Thanks again for responding!
Aug 9, '02
Occupation: Labor, Delivery, Post Partum and Newborn RN
10 year(s) of experience
OB, Post Partum, Home Health
Joined: Dec '00; Posts: 291; Likes: 34
I would agree with shay. I also had a pt that had a skin infection on her back and couldn't have one because it would introduce the skin infection into the epirual space and possible to spinal fluid if needle went too far. Also had a pt with recent craniotomy that couldn't have one.
Another good source for this question would be to ask an anesthesiologist or CRNA (certified registered nurse anethesist) I think that there may be a anesthesia nurse bulletin board on this site.
Aug 12, '02
Joined: Apr '02; Posts: 38,750; Likes: 16,271
BLEEDING disorders!!!!! like hemophilia or severely low platelet counts may be a reason to rule any regional anesthesia. Also like said above, any problem with spinal access; e.g. scoliosis, previous injury or surgery or s/s of infection are reasons I have seen why. Also allergy to the meds used in the epidural or spinal space may exclude some; although there are such a variety, they CRNA/MDA can usually work around it. Hope this helps.