pitocin and oxygen

njmomstudent · Jul 13, 2010

I definitely had oxygen in between pushing breaks... mind you, my IV infiltrated towards the end so I wasn't getting the pit anymore (which REALLY sucks when you stop having contractions right as the baby is crowing and have to push the baby out with no contractions behind you). Is there a reason you wouldn't give oxygen while on pit??

CrazierThanYou · Jul 13, 2010

I have two children. I was given pitocin with both of them and oxygen with neither. Is that strange?

jennf83 · Jul 13, 2010

We only use oxygen when a patient's condition warrants it, regardless if you have pitocin running or not. For example, if a pt is having recurrent late decels we'll give some o2.

klone, MSN, RN · Jul 13, 2010

Yes, I agree with the previous poster. O2 is part of intrauterine fetal resuscitation, and is used whenever the baby is having decels, or is otherwise showing signs of stress, regardless of whether the mom is on Pit. If she IS on pit, and baby is stressed, we would reposition mom, put on 02, and give her a fluid bolus. If that doesn't help, then we would turn the pit off.

PetiteOpRN · Jul 13, 2010

If something were to happen to the baby, and you are asked to defend your actions in court, can you justify having both pit and O2 going at the same time?

It is my understanding that if you are giving O2, the baby is being stressed, and you are trying to alleviate that stress. Pit causes stress. The two seem contraindicated.

If I'm giving a patient an IV drug and they start having an allergic reaction, I give benedryl, but if I continue the dug causing the reaction, that would continue to put the patient at risk. Wouldn't the pit/O2 be handled in a similar way?

jennf83 · Jul 13, 2010

I've seen pitocin used and never cause the baby stress at all, the babies will look perfectly happy (as we call it). Oxygen use is a resuscitative measure. Even if my patient starts having decels, we change positions first, we dont necessarily go for o2 right away because sometimes just changing positions stops the decels.

klone, MSN, RN · Jul 13, 2010

If something were to happen to the baby, and you are asked to defend your actions in court, can you justify having both pit and O2 going at the same time?
It is my understanding that if you are giving O2, the baby is being stressed, and you are trying to alleviate that stress. Pit causes stress. The two seem contraindicated.
If I'm giving a patient an IV drug and they start having an allergic reaction, I give benedryl, but if I continue the dug causing the reaction, that would continue to put the patient at risk. Wouldn't the pit/O2 be handled in a similar way?

Pit *can* cause stress. It doesn't always cause stress. If a mother was on pit for several hours, and the baby has handled it just fine, but then the mom gets an epidural and has a hypotensive episode and FHTs go in the toilet, then it's pretty easy to prove that it was the epidural that caused the problem, not the Pit.

You wouldn't make it in OB very long if you turned off the pit every time baby had a decel. Doing the resuscitative efforts I mentioned above and THEN turning off Pit if those efforts aren't effective, are perfectly acceptable by both ACOG and AWHONN standards. As long as I'm following AWHONN standards in my care (while also using my common sense, of course), I feel pretty well protected in the case of litigation.

clwb2008 · Jul 13, 2010

when I worked in L&D we would not routinely use O2 w/ oxytocin unless necessary for decels etc.

PetiteOpRN · Jul 13, 2010

Pit *can* cause stress. It doesn't always cause stress. If a mother was on pit for several hours, and the baby has handled it just fine, but then the mom gets an epidural and has a hypotensive episode and FHTs go in the toilet, then it's pretty easy to prove that it was the epidural that caused the problem, not the Pit.
You wouldn't make it in OB very long if you turned off the pit every time baby had a decel. Doing the resuscitative efforts I mentioned above and THEN turning off Pit if those efforts aren't effective, are perfectly acceptable by both ACOG and AWHONN standards. As long as I'm following AWHONN standards in my care (while also using my common sense, of course), I feel pretty well protected in the case of litigation.

I've never worked in OB, but when I was in labor, I was pulled off of pit when O2 was started and told that the pit was a contributing factor.

It makes sense that there might be other more significant factors that would cause late or prolonged decels, but if the pit could be contributing at all, it seems counter-intuitive to leave it on and see what happens. But like I said before, I've never worked in OB and I'm not familiar with ACOG and AWHONN standards.

Valerie RN, BSN · Jul 13, 2010

Pit *can* cause stress. It doesn't always cause stress. If a mother was on pit for several hours, and the baby has handled it just fine, but then the mom gets an epidural and has a hypotensive episode and FHTs go in the toilet, then it's pretty easy to prove that it was the epidural that caused the problem, not the Pit.
You wouldn't make it in OB very long if you turned off the pit every time baby had a decel. Doing the resuscitative efforts I mentioned above and THEN turning off Pit if those efforts aren't effective, are perfectly acceptable by both ACOG and AWHONN standards. As long as I'm following AWHONN standards in my care (while also using my common sense, of course), I feel pretty well protected in the case of litigation.

You definitely wouldn't last long if you turned pit off with every decel. Doctor's would be angry and honestly wouldn't let it fly. Not to mention that women would get more c-sections because of prolonged rupture of membranes. I just didn't know how it would look in court.

klone, MSN, RN · Jul 13, 2010

I've never worked in OB, but when I was in labor, I was pulled off of pit when O2 was started and told that the pit was a contributing factor.
It makes sense that there might be other more significant factors that would cause late or prolonged decels, but if the pit could be contributing at all, it seems counter-intuitive to leave it on and see what happens. But like I said before, I've never worked in OB and I'm not familiar with ACOG and AWHONN standards.

Okay, but what do you do in a situation where a woman is SROMed > 24 hours or 42 weeks' gestation and not actively laboring. You HAVE to augment labor to get her delivered. Sometimes you don't have a choice to use Pitocin in order to get the baby delivered. As long as baby responds to the resuscitative efforts and the heart tones are okay, then it's prudent and necessary to continue the Pit.