Use of D5LR as base fluid intrapartum

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Specializes in Labor& & Delivery.

I have worked in inpatient OB for 5 years now in the military and the base fluid for our patients during intrapartum has been LR usually at a maintenance rate of 125ml/hr. If we have diabetics we will give D5LR as the maintenance fluid. Providers are now requesting that all patients be given D5LR. Can any of you give me feedback on protocols and use of D5LR as a maintenance fluid. Evidenced based practice guidelines would be helpful. I have tried searching online for resources/research and have found none.

Thanks,

Julian

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Specializes in Labor & Delivery.

It's interesting to me that you use D5LR for diabetics. We only use LR for diabetics. Some of our providers request D5 for nondiabetics. I was taught at the first hopital I worked at to never bolus with D5 d/t the fact that it put the babys pancreas in overload and the baby would have hypoglycemic issues after delivery. I have worked in several facilities and each of them did things very diffently in regards to fluids. Also I see that you work in a military facility. I was just hired at Naval hospital and have'nt started yet. How do you like working in a military hospital? I'm civilian and have been told by folks that have worked there that they aren't very accepting of civilian personel. Can you give me some insight based on your experience? Thanks!

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Specializes in Labor& & Delivery.

In regards to your question about civilians working for the military. We love the civilians that work for us. I am in the AF so I can't speak for the Navy; however, we all play together like a big family. I assume the Navy nurses and docs do the same.

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We use LR at 125/hr and we use NSS for our diabetics. If a diabetic is on an insulin drip we will often use D5NSS so they have some substrate. One of our triage hospitalists has recently started ordering D5LR for all normal laboring patients, and when I questioned this order I was told that recent studies have shown better outcomes with D5LR. It was busy and I didn't get to have a discussion as to what the outcomes were, etc... and I've never had time to research it myself. So based on his response to me, I am assuming that there is research out there somewhere, but I don't know what/where at this point. I'd do some investigating for you, but I'm up to my eyeballs in reading and finding research articles for school...no time to look up items of interest right now.

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One of our triage hospitalists has recently started ordering D5LR for all normal laboring patients.

Why would a hospitalist be involved on any level at any time with routine OB patients?

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Why would a hospitalist be involved on any level at any time with routine OB patients?

We do about 10,000 deliveries/year. We have a very busy triage unit that is always staffed with an OB hospitalist. He/She sees the patients, then calls the patient's attending to discuss the plan of care. He/She writes initial orders on the patients who get admitted to L & D.

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Specializes in Community, OB, Nursery.

We have WHNPs and CNMs who function much the same way. They work exclusively in triage and decide who gets admitted, write admitting orders, etc.

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