Pitocin infusion: Induction vs PostPartum

[mormor]

This may sound like a stupid question, but I'm a new OB nurse and I am confused about something.

When we are inducing our patients, we usually have 1000 ml LR's as a main line infusing at about 125 ml/hr. The Pitocin runs on it's own pump starting out a 2 mu/min and is infused into the main line LR's through the port closest to the patient. I was instructed that Pitocin is never the main line infusion. If we have a pre-eclamptic patient, a separate IV site is established and the mag has it's own channel, and is also infused through the mainline LR's.

Postpartum, we run the pitocin (20 units in 1000 ml LR's) wide open. My question is, must it still be infused into LR's or can it be main line? I keep getting conflicting information on this and would appreciate any input from all of you wonderful experienced OB nurses!

Thanks!

[klone, MSN, RN]

You can mainline pit postpartum.

[mormor]

Thank you! That's what I thought and have been doing and then a nurse scared the bejeezus out of me when she told me to never ever mainline pit! Whew! I'm so relieved!

[Elvish, BSN, DNP, RN, NP]

It's different postpartum because you aren't worried about having to shut off pit quickly for a baby or uterus in distress. And if you have to bolus for the same reason, you surely don't want to be bolusing a mainline of pit.

[MKS8806]

Ditto what the others said. Think about the reason you are infusing pit:

Labor - stimulate contractions, but not to cause tachysystole as long as you have fetal tolerance. You need to be able to shut off the pit immediately and bolus fluids if needed. If your pit is your mainline and you start a bolus, you will bolus the pit that remains in your mainline.

PP - bolus pit in order to contract the uterus and minimize bleeding. The side effects you be watching for in labor are no longer an issue.

[mormor]

Thanks all for your great responses! I feel better knowing that my thought processes were correct after all. As a new OB nurse, I'm discovering how differently some of the nurses on my unit do the same things - this is such a great place to access expertise! Thanks again!

[Hushi05]

As a new OB nurse, I'm discovering how differently some of the nurses on my unit do the same things ...

Do you have policies/procedures on your unit which would answer your question (and which would ensure that all of the nurses are doing things the same way?)

We have a little split port extension which comes off the IV hub so we don't have to start two IVs if we're running mag, pit and LR. (It gets a little more complicated if we're also running insulin and AZT- in that case we do start two IVs).