Oxygen administration during labor

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I am a still a pretty new nurse....only three years into it now. I started fresh out of school in labor and delivery. WOULD NOT RECOMMEND THAT to you new grads! When I was orienting, an experienced nurse told me to give 15L/min of oxygen via face mask during intrauterine resucitation. So I did. And charted it. For about a year. Well, eventually I discovered that the standing order was for 10L/min. Now, I am a worried that I have SCREWED up big time and that I hyperoxygenated my patients causing harm to the fetus and their tiny fragile organs! I am petrified that I could have caused harm. Please help a young scared nurse!!! Could that extra 5L do damage in this case? How big of a "OOPS" is this in the nursing world of labor and delivery?

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Hehehe, I've got good news for you. You have been worrying about little to nothing. You've been doing a little oops. In reality, a patient is lucky to even get an FiO2 of 0.8 on a well secured non-rebreather mask. The difference between 10-15 LPM is really only a matter of increased flow.

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I am a new grad and have an interview with L& D...any advice? Why would you not recommend going straight to L& D from school?

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GilaRN- Thank you SOOO much! You have no idea how worried I have been...literally sick to my stomach!

Cajunmom- Well, don't get me wrong. I LOVE labor and delivery, but after a couple years into it I realized how limited I made myself by not getting some basic med surg experience. It is truly a specialty and after so long you want to scream and run if an 85yo man with chest tubes and wounds comes your way! Just wish I had gotten some more basic nursing skills mastered. If I could do it again I would go into med surg for at least a year.

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Specializes in Perinatal, Education.

I also went into L&D right after school and have not regretted it. Most L&D nurses that I have worked with that worked med-surg first have admitted that they have forgotten most of it after a few years of L&D. Also, things change and you can't hope to keep up your medical surgical stuff when you no longer practice it even if you started there. I now teach OB and nursing fundamentals (brand new nursing students) and I LOVE it!

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Specializes in Nurse Leader specializing in Labor & Delivery.

Actually, new research indicates that in order to raise O2 levels high enough that it will benefit the fetus, flow must be at least 12-15L, not 10. A lot of facilities have not changed their orders, but best practice based on research is that it should be 12-15.

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Specializes in Inpatient Obstetrics, Fetal Monitoring.

Klone, do you have helpful avenues for research articles. It gets to be my new project, how to intervene properly with O2. So the discussion of increasing liter flow or to change to non-rebreathers is what I need info on... Help a girl out...

K

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Specializes in L&D,Wound Care, SNC.
I am a new grad and have an interview with L& D...any advice? Why would you not recommend going straight to L& D from school?

I went straight into L&D and now have 5 years experience. If you plan on staying in L&D there is absolutely nothing wrong with it. Unfortunately, in this job market if you are looking to branch out you may find it challenging to land an interview. Due to my husband's new job, deployments, and my daughter in pre-k I cannot find affordable childcare that will transport her to school to accommodate a hospital nurse's schedule. I am aggressively searching for anything that I feel I am remotely qualified for and have not landed an interview. What sucks is, there are L&D jobs where I am, it just won't work for my family right now. :crying2:

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Specializes in Obstetrics/Case Management/MIS/Quality.

i remember a respiratory therapist once telling me not to use more than 6l/min via a face mask. if using more than that, you need to change to a non-rebreather. anyone else hear similar information?

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Specializes in Nurse Leader specializing in Labor & Delivery.

NRB masks is what we use.

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i remember a respiratory therapist once telling me not to use more than 6l/min via a face mask. if using more than that, you need to change to a non-rebreather. anyone else hear similar information?

no; however, you need at least 6lpm with a simple face mask to wash out carbon dioxide. slower rates can result in rebreathing.

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Specializes in Obstetrics/Case Management/MIS/Quality.
no; however, you need at least 6lpm with a simple face mask to wash out carbon dioxide. slower rates can result in rebreathing.

thanks for clearing that up, your explanation sure makes more sense! :)

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