Pit Inductions---How much do you increase?

[LDR-RN]

Our hospital USUALLY begins pit inductions with us starting at 2mu/min and increasing by 2mu every 30 min. One of our docs has started a new routine for her pt's starting at 6mu and increasing by 6mu every 30 min. Just wondering how everyone else out there does their inductions and their thoughts on it. Thanks

[RNLaborNurse4U]

Our slow protocol: start at 1mu, increase by 2 mu Q 30 minutes.

Rapid protocol: start at 2mu, increase to 4 mu in 15 min, 8mu in 15 min, 12mu in 15 minutes. (Rapid first hour) Then increase by 2mu Q 30 min until adequate contraction pattern. Can go as high as 30mu/min without addition orders. Anything above 30mu/min needs another written order with parameters. Can only go up to 40mu/min.

I have sometimes gone up as high as 30mu/min. Very, very rarely as high as 40mu/min. Most women will get a nice labor pattern with cervical change in the 12-20 mu/min zone.

[RNBelle]

Our orders are 3mus q 15-20 mins but I follow the national recommended standards of starting at 1-2mu's and increasing 1-2 q 30 mins. If you have access to any perinatal journals you will find articles stating that. Remember you are the one playing with the pit, not the dr. If he wants to push the limits he can come do it himself. Thats why I love working night shift. The docs aren't there to bug me on how I am running my pit.

[SmilingBluEyes]

This is why membership in organizations such as AWHONN is critical; you will know the current evidence-based practices are and where to find them. The journals you receive are packed full of information such as this. Those who are using high doses of pitocin, greater than 20-30mu/min are risking fetal hypoxia and acidemia as well as maternal hemorrhage after delivery.