Published Mar 12, 2005
A question came up on our LD unit and I was wondering if anyone knew the answer. Is there a standard drip concentration that is preferred by ACOG? Thanks for your help.
babyktchr, BSN, RN
Our pitocin comes pre-mixed 20units in 1000cc. That is what we did when we had to mix it also. One doc liked 10units in 1000cc.
I know there used to be different concentrations of pit years ago...I don't know the specifics, just heard nurses talking about it. I don't know that there is a standard thru ACOG, just be sure you know how many milliunits you are giving no matter what your concentration.
We mix our own pitocin. We usually start off with 10 units of pitocin in 1000cc. Sometimes the doctors double strength it with 20 units. Then once the baby is born, we administer 20 or 30 units of pit.
We mix our own, 20units Pitocin in one liter of LR
We mix our own pit- 20 units in 1000cc. If pit is not running @ delivery of the placenta, we add 20 units to the LR that's running or give 10 units IM.
We used to always mix our own pit..but then the pharmacy informed us one day that that would no longer be allowed. I don't know what happend or what power from above led them to this decision...but now we have premixed pit in D5 or NS. It is kinda nice actually. We still have pit on the floor for emergencies or IM use...but still use the premix.
I don't know is there is a specific mixture standard. There of course is the standard of wanting to have at least a minute between contractions. Different places use different mixtures.
We do the 2 amps of pitocin in a litre of D5LR thing. Then we go along the protocol of 1,2,4,6,8,Mu every half hour. We can play with that and go up 1 or down 1 Mu if the person is very sensitive. We can turn it off, etc. We have different standards of where you have to begin if you have turned the pit off for any specific reason and are starting again. It depends on WHY the pit has been turned off and for how long.
We usually mix our own pit but now we have it also supplied by pharmacy. Personally, I prefer to mix my own because then I know what I am giving. We usually mix our own though because we tend to forget that we have the premixed bags.
The standard is moving toward PHARMACY mixing all pitocin in the future. The concentrations vary. I have worked where they put 10 units in 1liter, or 20 units in 1 liter, or even 30 units in 500cc (which to me makes sense since pitocin mocks ADH and causes water retention). But the "standard" as to how it is mixed does vary from institution to institution. But expect to see pharmacies pre-mixing that more and nursing doing it less and less in the future.
We use 10 units in 1 liter LR. We mix ourselves. We start at 1 mu/min and increase q 1/2hr by 2 mu.
we use 500cc d5lr w/30 units pit for induction and 1000cc d5lr w/20 units pit after delivery. pharmacy mixes ours, except the crna's mix some for c/sections if we dont have the 1000 bag up from pharmacy. for induction,some docs want pit titrated high dose (6mu-6cc/hr q 15min) and some order low dose-titrate 2mu(2cc/hr) q15 min.
we still mix our own, 30 units in 500ml
wow ..interesting to see the diversity of concentration and the use of D5.
Any ideas or references for what is the standard here?
i heard that D5 should not be used but only LR...
And dos ACOG and.or AWHONN have recommandation re the concentration as well as the timing for augmentation?
Our protocol is very strict; LR only, 10 units in 1000cc and augmentation 1mu q 15min, call Doc at 10mu in order to get permission to go beyond, that is 1mu q 30 min. do not go over 20 mu.
We had recently the case of an induction who had been AROMED at 2 cm..
after cervidil on a very unfavorable cervix, was pitted all day w/o any results and got yelled at by doc b/c she refused to go over 20 mu...
the bb was very tacky, no variability for a long long time, no accels... ended up by a c/s after the doc was called to the floor by a collegue after much effort.....
Ginny DOULA RN SNM
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