Re: [ozmidwifery] gastric washes
Sue Many of us understand your frustrations!! we hope you Hang In there I feel sure you are offereing view and opening windows for many around you Denise Hynd Let us support one another, not just in philosophy but in action, for the sake of freedom for all women to choose exactly how and by whom, if by anyone, our bodies will be handled. - Linda Hes - Original Message - From: Sue Cookson [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, June 07, 2005 6:07 AM Subject: Re: [ozmidwifery] gastric washes Hi again and thanks to Robyn and Marilyn for your replies so far, I fully agree that gastric washes are not warranted, but having been faced with babies who receive no breastmilk at all when the mothers choose to artificially feed, I wonder at their different mechanism of clearing a gut full of mucous/blood/mec. Colostrum kick starts all sorts of mechanisms - from mechanical to hormonal etc etc. Really surprises me that there is no formula substitute for colostrum to start these A/F babies off with. That's not to say that all the babies who received gastric washes were a/f, they weren't. Also Marilyn if you talk of babies who are born rapidly, then I guess every c/section baby would fit this category... The mechanised birthing and protocols and the way most midwives just follows things and don't query them really amazes me. One amazed and frustrated student, Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- No virus found in this incoming message. Checked by AVG Anti-Virus. Version: 7.0.322 / Virus Database: 267.6.3 - Release Date: 6/06/2005 -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] gastric washes
Hi Sue This practice has always astounded me too. Although I will admit to 'doing' a couple over the years- but never ever got any returns so now I refuse to do them if requested and have a discussion with the Paed who requests it or the Midwife who thinks she might just give it a go to clear a mucousy babe. (Wont go into how ineffective a lavage is for the mucousy newborn just now), So if you do see any actual recent evidence based references I'll be truly amazed:) Cheers Alesa -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] gastric washes
Hi Sue, Your request reminded me of an incident I had as a new graduate. A very mucousy baby hadn't fed for 6 hours and as per the hospital policy of where I was working I had to do a blood sugar level which came in at 4mmol/l, as I went to reassure mum I was told by my supervisor that the reading was due to the mucous in the tummy and not milk and therefore I needed to do a lavage before tube feeding the baby with some formula otherwise the blood sugar could plummet dangerously. To this day I still can't work the logic out of this and despite much discussion she didn't see my point of view! Research into the much used and abused lavages would be great. cheers Wendy. - Original Message - From: Alesa Koziol [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, June 07, 2005 6:42 PM Subject: Re: [ozmidwifery] gastric washes Hi Sue This practice has always astounded me too. Although I will admit to 'doing' a couple over the years- but never ever got any returns so now I refuse to do them if requested and have a discussion with the Paed who requests it or the Midwife who thinks she might just give it a go to clear a mucousy babe. (Wont go into how ineffective a lavage is for the mucousy newborn just now), So if you do see any actual recent evidence based references I'll be truly amazed:) Cheers Alesa -- 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] gastric washes
Hi all, Need your help finding references/articles on gastric washes for neonates, also any first hand observations or thoughts. I've just returned from a week in Adelaide doing a postpartum placement and was amazed to see so many gastric washes being done. When I queried the practice and asked for protocols and policies to look at, I was told that 'we've been doing them for 30 years and they work'. To hell with best practice and evidence!! Any comments would be welcomed, Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] gastric washes
Hi Sue Jan and I will be your way before long. Just wondering if you want me to include you on the LIST of Australian Midwives wanting/needing/seeking professional indemnity and provider numbers? Gastric washes/lavage alter the gastric enzymes and flora. No need for these invasive procedures. Colostrom and breastmilk is the answer to cleaning and assisting the function of the alimentary system. In my experience gastric washes are for people who overdose or swallow dangerous substances. No references at present, no evidence needed, common sense prevails. -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Sue Cookson Sent: Monday, 6 June 2005 6:17 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] gastric washes Hi all, Need your help finding references/articles on gastric washes for neonates, also any first hand observations or thoughts. I've just returned from a week in Adelaide doing a postpartum placement and was amazed to see so many gastric washes being done. When I queried the practice and asked for protocols and policies to look at, I was told that 'we've been doing them for 30 years and they work'. To hell with best practice and evidence!! Any comments would be welcomed, Sue -- 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] gastric washes
I had only known of a gastric lavage being done once when I worked in California and that was to a baby who had swallowed a tummy full of blood birthing through an abruption (apgars of 8 and 9, c/s birth). In his case it seemed quite reasonable though perhaps also unnecessary. It seems to be quite a common practice here though and at one time seems to have been done routinely at birth (there is a check point for it on the care path header). The usual scenario seems to be a mucousy baby who is positing amniotic fluid during the first 24 to 48 hours often after a rapid (5 to 15 min) second stage. My practice to reassure the parents that the fluid will pass through and all will be well, which it is if given half a chance, but often the next shift someone has lavaged the baby. It seems at one time the gastric aspirate was cultured for GBS? (also still on the care path header). The practice had not even registered in my consciousness until working here. marilyn - Original Message - From: Sue Cookson [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Monday, June 06, 2005 1:17 AM Subject: Re: [ozmidwifery] gastric washes Hi all, Need your help finding references/articles on gastric washes for neonates, also any first hand observations or thoughts. I've just returned from a week in Adelaide doing a postpartum placement and was amazed to see so many gastric washes being done. When I queried the practice and asked for protocols and policies to look at, I was told that 'we've been doing them for 30 years and they work'. To hell with best practice and evidence!! Any comments would be welcomed, Sue -- 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] gastric washes
Hi Sue: I found this one on pubmed after entering: neonates AND gastric lavage. marilyn Eur J Pediatr. 1999 Apr;158(4):315-7. Related Articles, Links Is gastric lavage needed in neonates with meconium-stained amniotic fluid? Narchi H, Kulaylat N. Saudi Aramco - Al-Hasa Health Center, Saudi Aramco Medical Services Organization, Saudi Aramco, Mubarraz, Saudi Arabia. [EMAIL PROTECTED] We compared the incidence of complications from meconium-containing gastric fluid in a group of neonates born with meconium-stained amniotic fluid (MSAF) who did not routinely have gastric lavage prior to feeds, versus a group who had elective gastric lavage before the first feed. In the first group, 275 neonates born with MSAF were fed without prior gastric lavage. While 13 developed feeding problems, the other 262 infants (95%) who did not undergo routine gastric lavage remained free of later feeding difficulties or secondary meconium aspiration. In the second group, all 227 neonates with MSAF had elective gastric lavage performed after birth. All remained free of later feeding difficulties or secondary meconium aspiration. CONCLUSION: Our data suggest that gastric lavage is not necessary in most neonates born with meconium-stained amniotic fluid, regardless of the thickness of the meconium-stained fluid, as no complications from meconium-containing gastric fluid were observed. Publication Types: a.. Clinical Trial b.. Randomized Controlled Trial - Original Message - From: Sue Cookson [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Monday, June 06, 2005 1:17 AM Subject: Re: [ozmidwifery] gastric washes Hi all, Need your help finding references/articles on gastric washes for neonates, also any first hand observations or thoughts. I've just returned from a week in Adelaide doing a postpartum placement and was amazed to see so many gastric washes being done. When I queried the practice and asked for protocols and policies to look at, I was told that 'we've been doing them for 30 years and they work'. To hell with best practice and evidence!! Any comments would be welcomed, Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. --production.springer.de-OnlineResources-Logos-springerlink.gif
Re: [ozmidwifery] gastric washes
Hi again and thanks to Robyn and Marilyn for your replies so far, I fully agree that gastric washes are not warranted, but having been faced with babies who receive no breastmilk at all when the mothers choose to artificially feed, I wonder at their different mechanism of clearing a gut full of mucous/blood/mec. Colostrum kick starts all sorts of mechanisms - from mechanical to hormonal etc etc. Really surprises me that there is no formula substitute for colostrum to start these A/F babies off with. That's not to say that all the babies who received gastric washes were a/f, they weren't. Also Marilyn if you talk of babies who are born rapidly, then I guess every c/section baby would fit this category... The mechanised birthing and protocols and the way most midwives just follows things and don't query them really amazes me. One amazed and frustrated student, Sue -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] gastric washes
Hi Sue, i too searched in medline and there is only one article - that was put up before - on gastric lavage in bubs possible showing that this is not a widespread practice. here is some other info on lavage in drug OD that isnt direclty related but interesting and some of the info could be paralleled in mec-cases. eg that very little of the drug (or mec) is actually retrieved and it needs to be done within 1 hour of ingestion.. as well as the discomfort caused in someones first day of life!which i think is significant Gastric lavage ...lavage can retrieve drugs, either whole or in fragments. However, controlled studies indicate that the amount of the ingested drug retrieved is, on average, very small and varies widely, and that lavage probably does not alter the clinical course of the patient. The procedure is time consuming, labor intensive, very uncomfortable for the patient, and carries a real risk of aspiration. However, in certain situations, any amount of drug retrieved may be clinically beneficial. Conclusion: Most clinical toxicologists agree that lavage should be performed only when a patient has ingested a large amount of a potentially dangerous drug (eg, a calcium channel blocker, a tricyclic antidepressant, or a [beta]-blocker) and comes to the emergency department within an hour of ingestion. i hope that your placement improves some :) Emily Discover Yahoo! Find restaurants, movies, travel & more fun for the weekend. Check it out!
