pitocin protocol

According to our policy, we can go up to 20 mu. If after 20mu, the doctor wants more pitocin, we go to 30mu. A while back, a group of new residents wanted to go to 40mu, but not one nurse would do that.

Originally posted by mommanurse

I'm just curious how what the pit protocol is at other facilities.

We once had a doctor who thought running pit up to 40 was okay. we didnt agree. he even said we could go up to 60 if cervical changes were not being made, he never worried about hyperstim... wondering if anyone else has seen doctors so aggressive and possibly dangerous with pitocin orders.

I'm new to this web site, therfore I don't know if this will come out right or not,....At our hosp. we have a protocol to go up to 20 and if not effective then we have recieved an order to go up to 30 then another to go to 40, usually by this time they have an IUPC

we run our pitocin on a sliding scale. we add 60 units to 1000 cc d5lr and run from 1 mu/min to 54 mu/min, until adequate uterine activity occurs. if hyperstimulation occurs we back it down or turn it off.

Valene,

Just wondering if your babies have a lot of blood sugar probs

from the Pitocin mixed with the D5LR instead of just plain LR,

and if your facility has many uterine ruptures from the Pitocin protocol they use?

Our protocol allows up to 42mu/min of pit. There's no reason to be afraid of pit if it is used appropriately. Increasing pit is a nursing judgement, so if you are monitoring your patient closely, you will be less apt to hyperstim. Also the great thing about pit is, when it's off, it's off. Love that short half-life!!

We also mix our pit with D5LR, and don't have baby sugar problems as a result. We can go to 20, then to 30 with physician order. I have gone higher than that before with the physician present and an IUPC. No way would I go higher than 30 with an external.

are you talking about hypoglycemia with pitocin and d5lr?

we have maxed out at 54 mu/min on a patient with only cramping for 6 hours, shut the pit off, and start over again the next day.

54 mu/min with mom smiling all day.

we mix 30 unit pit in 500cc of d5lr to give a 1:1 ratio. we start at 2 and increase 2-4 every 15-30 min until good ctx pattern. We can go up to 40 then need order after40. jama

30 Units pitocin to 1 L D5/LR

most docs write to start at 1-2 mU, and increase by 1-2mU q15"...

max 20mU for about 50% of our mds...

max 32mU for most others...

a few don't believe in a max amt.

most of us will NOT run >20 mU/min without IUPC

We can go to 42 mu but if hyperstim, we back off. Just recently our doctors started cutting back and not being so aggressive with pit, with increases of only 1 mu instead of 2mu or 6 mu increases. we mix 20 mu/1000 LR.

We, unfortunatley, don't have a technical limit, but have no problems backing down using nursing judgement, when there is a problem with resting tone, or the baby crashes ( or we just dont like the strip). I have rarely seen us go beyond 30 something. Plus, haven't you found if someone isn't ready to go into labor, no amount of pit will do it? I have a problem with our docs and cytotec. Some years ago our chief decided he read an article on the internet where cytotec was used to induce labor. I mentioned I wasn't comfortable with us not having a protocol and EVENTUALLY, years later, they are working on one because we complained often enough and refused to give it. They are STILL sarcastic when they have to go in and do it. Some will even tell the patient that the nurse "doesn't feel comfortable giving them the "litttle bitty pill".. I have no problem countering with why that is so...

Our pit policy does mention that a doc must be available for it to be started and they have heartache with that too sometimes....

Always a battle...

Forgot to mention that our protocol is 10 units pit in 1000cc lr start at 1-2 mu and increase every 15-20 minutes until uc are so far apart lasting so often ( standing orders and they fill in the blanks) to a maximum of.....(whatever)