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Re: Admitting labs, wasTocolyticsFrom: Garry E. Siegel, M.D. (garrys@mindspring.com)Tue Jun 14 10:24:44 2005
Good question. I was told by one of the anesthesiologists at one hospital that their guidelines say that the platelets should be checked before placement, yet I cannot find it in the guidelines on the American Society for Anesthesiologists' website. However, he said that using clinical judgment was OK, too, i.e. a multip presenting at 5 cm. wanting an epidural ASAP can be assessed by the anesthesiologist and an epidural placed before the platelet count (which could take long enough, 45 to 60 minutes) such that the patient doesn't get the epidural. That said, at another large hospital, it is the Anesthesiology departments policy to virtually always get the count, although I've had a rare exception to that. Digressing, it seems reasonable to ask for a platelet count before putting a large needle near epidural veins, although why not get a PT/PTT, too? I suspect this is because thrombocytopenias occur with some frequency in L and D, mainly from PIH or gestational thrombocytopenia, although the latter is rarely less than 100K. Garry
At Tue, 14 Jun 2005, David Rivera wrote:
>
-- Garry E. Siegel, M.D. Private Practice Roswell, GA
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