Pitocin IVP?

Specialties Ob/Gyn

Published

I had a CNM tell me to push 10u Pitocin IV the other day. I've never seen it ordered that way (even 20+ years ago) so I had to look into it and ended up not doing it based on pharmacy recommendations.

Is this something that you have seen or done? We give a lot in a running IV bag 10-30u in 500-1000cc but never IVP.

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

I am assuming this was post-placental. If she has an IV we always just give it as a bolus in LR. I mean, I guess you COULD theoretically give it IVP if you don't want the mom to get all the extra fluid, but I have to assume that would hurt like a mo-fo. Never looked into the safety recommendations on it because I've never encountered anyone ordering it that way before.

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That's a very odd order. I've personally never heard of it, I always give it IM or diluted in a bag of 500/1000ml fluid.

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I am assuming this was post-placental. If she has an IV we always just give it as a bolus in LR. I mean, I guess you COULD theoretically give it IVP if you don't want the mom to get all the extra fluid, but I have to assume that would hurt like a mo-fo. Never looked into the safety recommendations on it because I've never encountered anyone ordering it that way before.

Pharmacy said no don't do IVP. Apparently it can cause blood pressure drops. I wasn't expecting to hear that, I was expecting that it might not be ok for the same reason you mention. CNM said we used to do it like that all the time in the olden days.....but I'm no spring chicken and I've never seen it ordered that way. Patient didn't want IM or IVF hung even though she had a SL so that's where the IVP order came from.

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That's a very odd order. I've personally never heard of it, I always give it IM or diluted in a bag of 500/1000ml fluid.

Yes me too.

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CNM said we used to do it like that all the time in the olden days.....but I'm no spring chicken and I've never seen it ordered that way. Patient didn't want IM or IVF hung even though she had a SL so that's where the IVP order came from.
Well, even if they did do it that way in the old days (never heard of it either, I'm like you), if there's no policy for it and pharmacy says no, I think you made the right call. CYA, man. Odd that the patient didn't even want it IM. Hopefully she was breastfeeding....
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Well, even if they did do it that way in the old days (never heard of it either, I'm like you), if there's no policy for it and pharmacy says no, I think you made the right call. CYA, man. Odd that the patient didn't even want it IM. Hopefully she was breastfeeding....

Didn't want another needle experience I guess. In the end she didn't need it so all was well.....except for the part about me wasting time running around trying to figure out the IVP part. :dead:

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Didn't want another needle experience I guess. In the end she didn't need it so all was well.....except for the part about me wasting time running around trying to figure out the IVP part. :dead:
Ugh, hate that. *run around unit like chicken with head cut off looking for something doctor needs NOW* *find item* "Oh, it's fine, we don't need it now." :banghead:
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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
Didn't want another needle experience I guess. In the end she didn't need it so all was well.....except for the part about me wasting time running around trying to figure out the IVP part. :dead:

But hey, you learned something new! That's never a waste. :)

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