2008CaliRN

I used to work at a facility that required an xray if a proper count could not be done prior to the start of a stat case. It would be wise to search your policy and procedure reference and see if something like this is in place. It also would be wise to institute a policy if you don't find one. A minimal suture count (one or two needed to close the uterus) could be opened for a stat and then add the additional sutures with the view of a witness as the case progressed. Same thing for the laps. One package of 5 opened for the start of the stat, then add the additional laps after the urgency is relieved. I hope that this was helpful. We all learn from these situations. It will get better.

Lowering the IV fluid rate of the primary bag when giving Magnesium is where I think that practice came from. A total of 125 cc/hour is satisfactory hydration. Pitocin can contribute to patients retaining fluids, too, Is anyone using 500 cc bags with 30 units of Pitocin for this reason? Less volume is needed which can decrease the total amount of IV fluids that would be administered compared to the 1000 cc with 20 units of Pitocin. Years ago, I heard that the 500 cc of LR with 30 units of Pitocin would be the national standard but I have not yet seen this available.

I think that Pitocin is being over-used. I wish that we could allow patients to go in to labor more naturally. It seems like the convenience factor of inducing is trumping the health benefits of waiting for spontaneous labor.

Simply said, "yes". The March of Dimes among others have made a great effort to promote waiting until at least 39 weeks to electively induce labor. Inducing prior to 39 weeks is still allowed if there is a suspected medical reason that may compromise the pregnancy if delivery is delayed, i.e. oligohydramnios, growth restriction, diabetes, preeclampsia, etc. The fetus benefits from the extra maturity of the brain by delaying until at least 39 weeks. It would be presented best to your antepartum patients that the "womb" not the "hospital room" is the best place for the baby until 39 weeks.

I just wanted to know if anyone was willing to share their script used for follow up post partum discharge phone calls. We are going to start calling our discharged patients within the first few days after discharge to help improve our practice and hence improve patient satisfaction. Thank you in advance.