Re: [ozmidwifery] IV Synto for 3rd stage
hi kylie re whats been chatting on about you probably were at the same hospital. large teritary. but if it is hospital protocol and you are found not to be doing the protocol then it is your job which would you prefer. regards - Original Message - From: Kylie Holden [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, January 24, 2006 10:05 AM Subject: Re: [ozmidwifery] IV Synto for 3rd stage Hi Sharon This is exactly the reason for the hospital I am referring to...there once was a baby whose imperforate anus was not picked up and baby became very sick. I wonder if it's the same hospital? As far as I am aware, the research shows that the difference in accuracy between PA and PR is so slight that is is not significant, and therefore not a compelling reason to take temps PR. What makes this hospital's protocol so ridiculous is that even if the baby has already passed mec, we still have to do it PR! Even though they claim the only reason we must do it PR is to check for imperforate anus. In regards to the synt, I just remembered that I cared for two women only last week (still as a student!) who had had their dose of synto (one IM and the other IV that was flushed) and they both went on to have PPHs anyway. Makes you wonder... Kylie From: sharon [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] IV Synto for 3rd stage Date: Tue, 24 Jan 2006 08:33:18 +1030 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 happenseventually. 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
Re: [ozmidwifery] IV Synto for 3rd stage
hi kylie re whats been chatting on about you probably were at the same hospital. large teritary. but if it is hospital protocol and you are found not to be doing the protocol then it is your job which would you prefer. Regards Gee What about some lateral thinking! How about informing women about evidence and appropriate care, and giving them a choice!!! Slow in-roads to change but a least a chance of it when midwives work with women to inform and support them rather than with obstetric dominance that dictates and abuses JC -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] IV Synto for 3rd stage
I have got away with carfully suggesting that there are things I have to do (because they are hospital policy) but they can always refuse if they wish ;) rgds mike On 1/24/06, Justine Caines [EMAIL PROTECTED] wrote: hi kylie re whats been chatting on about you probably were at the same hospital. large teritary. but if it is hospital protocol and you are found not to be doing the protocol then it is your job which would you prefer. Regards Gee What about some lateral thinking! How about informing women about evidence and appropriate care, and giving them a choice!!! Slow in-roads to change but a least a chance of it when midwives work with women to inform and support them rather than with obstetric dominance that dictates and abuses JC -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- My photos online @ http://community.webshots.com/user/mike1962nz My Group online @ http://groups.yahoo.com/group/PSP_for_Photographers Life is a sexually transmitted condition with 100% mortality and birth is as safe as life gets. Unknown -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] IV Synto for 3rd stage
Hi Justine, You're right...the issue could be worked around by offering the mother a choice by giving her the facts. Then if she doesn't consent to it you could document it as such, ie Mother did not consent to PR temp on the baby, therefore PA temp was taken or something like that. I have found this whole conversation fascinating...I have had most of my placements at two of the bigger hospitals in this state, and both insist on PR temps. It made me assume that most hospitals still had this policy, despite evidence to the contrary. OK, next big question...anyone got references off the top of their heads to support this? I promise I will do my own research (!), but if anyone knows of any articles that would be great! Kylie From: Justine Caines [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: OzMid List ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] IV Synto for 3rd stage Date: Tue, 24 Jan 2006 22:28:27 +1100 hi kylie re whats been chatting on about you probably were at the same hospital. large teritary. but if it is hospital protocol and you are found not to be doing the protocol then it is your job which would you prefer. Regards Gee What about some lateral thinking! How about informing women about evidence and appropriate care, and giving them a choice!!! Slow in-roads to change but a least a chance of it when midwives work with women to inform and support them rather than with obstetric dominance that dictates and abuses JC -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. _ Make your dream car a reality http://a.ninemsn.com.au/b.aspx?URL=http%3A%2F%2Fcarpoint%2Eninemsn%2Ecom%2Eau_t=12345_r=emailtagline_m=EXT -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
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 http://a.ninemsn.com.au/b.aspx? URL=http%3A%2F%2Fninemsn%2Eseek%2Ecom%2Eau_t =752315885_r=Jan05_tagline_m=EXT -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. _ New year, new job there's more than 100,00 jobs at SEEK http://a.ninemsn.com.au/b.aspx?URL=http%3A%2F%2Fninemsn%2Eseek%2Ecom%2Eau_t=752315885_r=Jan05_tagline_m=EXT -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
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 happenseventually. 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 http://a.ninemsn.com.au/b.aspx? URL=http%3A%2F%2Fninemsn%2Eseek%2Ecom%2Eau_t =752315885_r=Jan05_tagline_m=EXT -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. _ New year, new job – there's more than 100,00 jobs at SEEK http://a.ninemsn.com.au/b.aspx?URL=http%3A%2F%2Fninemsn%2Eseek%2Ecom%2Eau_t=752315885_r=Jan05_tagline_m=EXT -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe
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 happenseventually. 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
Re: [ozmidwifery] IV Synto for 3rd stage
This is such a poor excuse because you are hopefully not inserting the thermometer far enough to prove that the baby has a continuous gut with no obstructions. The only proof of this is passage of meconium. Baby's that have meconium ileus will have perforate anus' but still have a obstructed bowel. I too have picked up a imperforate anus that was missed by 48 hours worth of midwives looking after a baby but I didnt need ot attempt to put a thermometer up his bum to tell I just needed to look. Recently we had a baby with very delayed passage of meconium and sometimes this can be stimulated by insertion of a rectal thermometer but I chose instead to give the baby a bit of anal massage which assisted it to pass a very sticky mecoium plug which I was surprised to hear that many of my colleagues had never seen before. Andrea On 24/01/2006, at 9:03 AM, sharon wrote: 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 happenseventually. 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
Re: [ozmidwifery] IV Synto for 3rd stage
Hi Sharon This is exactly the reason for the hospital I am referring to...there once was a baby whose imperforate anus was not picked up and baby became very sick. I wonder if it's the same hospital? As far as I am aware, the research shows that the difference in accuracy between PA and PR is so slight that is is not significant, and therefore not a compelling reason to take temps PR. What makes this hospital's protocol so ridiculous is that even if the baby has already passed mec, we still have to do it PR! Even though they claim the only reason we must do it PR is to check for imperforate anus. In regards to the synt, I just remembered that I cared for two women only last week (still as a student!) who had had their dose of synto (one IM and the other IV that was flushed) and they both went on to have PPHs anyway. Makes you wonder... Kylie From: sharon [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] IV Synto for 3rd stage Date: Tue, 24 Jan 2006 08:33:18 +1030 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 happenseventually. 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
Re: [ozmidwifery] IV Synto for 3rd stage
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 http://a.ninemsn.com.au/b.aspx? URL=http%3A%2F%2Fninemsn%2Eseek%2Ecom%2Eau_t =752315885_r=Jan05_tagline_m=EXT -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[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 http://a.ninemsn.com.au/b.aspx?URL=http%3A%2F%2Fninemsn%2Eseek%2Ecom%2Eau_t=752315885_r=Jan05_tagline_m=EXT -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] IV Synto for 3rd stage
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 http://a.ninemsn.com.au/b.aspx?URL=http%3A%2F%2Fninemsn%2Eseek%2Ecom%2Eau_t =752315885_r=Jan05_tagline_m=EXT -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
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 http://a.ninemsn.com.au/b.aspx? URL=http%3A%2F%2Fninemsn%2Eseek%2Ecom%2Eau_t =752315885_r=Jan05_tagline_m=EXT -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
