Hi
all,
There
are other ways to handle the risk of missing an imperforate anus. I
know a case of a baby dying from meconium ileus due to cystic
fibrosis. It was quite some time before it was realised that the baby had
not passed meconium. That workplace now has a sticker on the baby's chart
which must be completed by 24hours post birth stating whether or not the baby
has passed urine or meconium, and if not, to document that a paediatrician has
been notified. (I could probably get you a sample if you would like to show it
to your paed.) Then if any invasive measures are taken, at least they may be
justified, rather than subjecting all babies to the indignity and discomfort of
having something passed into their rectum.
Kind
regards,
Nicole.
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Alesa Koziol
Sent: Tuesday, January 24, 2006 6:37 PM
To: ozmidwifery@acegraphics.com.au
Subject: Re: [ozmidwifery] wasIV Synto for 3rd stage now rectal tempsPlease be assured that I am not killing the messanger here...............but really, are you really telling me that at your site all newborn infants are subjected to an invasive process because once upon a time a single baby had a problem?Alesa----- Original Message -----From: "sharon" <[EMAIL PROTECTED]>Sent: Tuesday, January 24, 2006 9:03 AMSubject: Re: [ozmidwifery] IV Synto for 3rd stage> 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
> >>>>>
> >>>>>_________________________________________________________________
> >>>>>New year, new job – there's more than 100,00 jobs at SEEK
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> >>>>>
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> >>>>>
> >>>>>
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> >>>>
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> >>>
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> >>
> >> _________________________________________________________________
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> >>
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