at the hospital i work in the paediatrician/neonatologist inisit on all
newborns have a rectal temp done for the first temp. i have been told when
questioning this from the clinical learning co-ordinator that there once was
a baby who had a imperferated anus and this was not picked up until too late
and the baby became very sick so it is protocol. also i was told that there
is a difference in temperature as when i looked this subject up for my own
interest if you take a temp axilla there is also many other factors which
come into play such as the air temp and if the thermometer is accurately
placed. the references i cant remember but the evidence suggested that for a
accurate reading we should be taking temperatures rectally for infants and
orally for adults not axilla and certainly not be the fold at the back of
the newborns neck.
regards
----- Original Message -----
From: "brendamanning" <[EMAIL PROTECTED]>
To: <ozmidwifery@acegraphics.com.au>
Sent: Tuesday, January 24, 2006 12:11 AM
Subject: Re: [ozmidwifery] IV Synto for 3rd stage
How amazing, rectal temps are so archaic !
I thought they went out with PR exams to assess dilation.
Poor you !
Keep questioning, that's how change
happens............................eventually.
With kind regards
Brenda Manning
www.themidwife.com.au
----- Original Message -----
From: "Kylie Holden" <[EMAIL PROTECTED]>
To: <ozmidwifery@acegraphics.com.au>
Sent: Monday, January 23, 2006 11:42 PM
Subject: Re: [ozmidwifery] IV Synto for 3rd stage
All debates regarding active v. physiological third stage aside, I was
referring to women who have had a jelco put in for whatever reason (IV
antibiotics in labour, epidurals, etc).
I completely agree with you Brenda, that the number of women who didn't
get their "required" dose of synto and who go on and have a (semi)
physiological third stage are evidence in favour of safe, "normal" 3rd
stage. Unfortuately this particular hospital doesn't take too kindly to
students coming in and questioning their protocols! We learnt that the
hard way when we (as students) tried not to take babies first temps
rectally...a protocol was soon put in place that this MUST occur!
Kylie
From: "brendamanning" <[EMAIL PROTECTED]>
Reply-To: ozmidwifery@acegraphics.com.au
To: <ozmidwifery@acegraphics.com.au>
Subject: Re: [ozmidwifery] IV Synto for 3rd stage
Date: Mon, 23 Jan 2006 15:18:48 +1100
Kylie,
We are presuming these are all high risk women you are dealing with as
otherwise there would be no need for her to have a jelco in place ?
I am including women who have epidurals in this category as this
automatically makes them high risk once they've deviated from the 'body
driven' course of labour.
Otherwise...............
Why would a low risk woman :
a. have a jelco in situ during labour ?
b. need an oxytocic ?
So assuming she is high risk you need to be very sure she gets the
oxytocic, she really needs it as her body has had its input overridden by
the initial intervention so it makes sense to flush the tubing & ensure
the accurate therapeutic dose is received.
Maybe you might put some thought out there in your workplace about how
all those women whose MW didn't flush & they therefore didn't actually
get their synt (or got a reduced/minimal amount) managed to have a
"normal" 3rd stage & no PPHs ?
Now there's an interesting question to ask your colleagues !!
With kind regards
Brenda Manning
www.themidwife.com.au
----- Original Message ----- From: "Ceri & Katrina"
<[EMAIL PROTECTED]>
To: <ozmidwifery@acegraphics.com.au>
Sent: Sunday, January 22, 2006 6:04 PM
Subject: Re: [ozmidwifery] IV Synto for 3rd stage
Hi Kylie
we actually give 5IU synto diluted in 10mls Normal saline, then flush
that through with a flush.
In the short time I have been in Middy even when we gave it not
diluted, it was still flushed.
katrina ;-)
On 22/01/2006, at 2:20 PM, Ken WArd wrote:
Proberly where it should sit for a normal birth. But when it is
advisable to
give synto, then I guess you should flush the line.
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] Behalf Of Kylie Holden
Sent: Sunday, 22 January 2006 12:14 PM
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] IV Synto for 3rd stage
Hi all
I'm a Mid student (who has finally finished all her birth
requirements...yay!) and this issue has only just come up for me over
the
last week or two. For the first time in two years, a midwife I was
working
with pointed out the importance of flushing through the synto if you
have
given it IV, if there was no drip running to flush it through.
This obviously makes sense, because if you don't flush it, the synto
will
just sit in the J loop or IV line. However, I had never actually seen
a
midwife do this before. Over the next few days I asked a few midwives
what
they do, and the responses I got ranged from "Why on earth would you
need to
do that?" to "Yes, of course you need to flush it!"
Any thoughts on this topic?
Kylie
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