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With our epidurals post c/s we use pcea's which are
quite different and easier to manage re adding more drugs than the epidural
syringe type plunger used for top-ups in birth suite (at least for me). I had
never seen these plunger type things before coming to oz so i don't
know where they exist elsewhere: have heard from a colleague in Ontario,
Canada that they also have the plungers and if the midwives are attending a
women in labour who has requested an epidural then the midwives do the care
after an ob consult (they do caseload independent practice in home, hospital,
and birth centre with ob nurses for the ob's and gp's in the hospitals). In the
hospitals I had trransferred to in washington and california they had used
pcea's in labour ward set up by the anaesthetist but monitored by the ob nurse
even if ordered by us in consult with an ob.
marilyn
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