Re: Policy needed for Nitroglycerine for head entrapment
From: Andrew Folley (agfolley@hotmail.com)
Sun Sep 3 14:14:39 2006
A good trick to remember is the nitro for relaxation. Draw up 5 mg nitro
and put in 100cc saline (stirred not shaken...kidding) and draw up 20cc
(20mcg) of this solution and give IV.
>From: "Lyndon Taylor" <lyndontaylor@msn.com>
>Reply-To: ob-gyn-l@obgyn.net
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>Subject: Re: Policy needed for Nitroglycerine for head entrapment
>Date: Sun, 3 Sep 2006 11:26:50 -0500
>
>a.. If the head is entrapped, we suggest administering a uterine relaxant
>(Grade
>2C<http://www.utdol.com/utd/content/image.do?imageKey=requ_pix/grade_13gif>).
>Options include a beta adrenergic agonist (eg,
>terbutaline<http://www.utdol.com/utd/content/topic.do?topicKey=Drug_L_Z/255495&drug=true>
>0.25 mg subcutaneously or 2.5 to 10 mcg/minute intravenously) or
>nitroglycerin<http://www.utdol.com/utd/content/topic.do?topicKey=Drug_L_Z/182768&drug=true>
>(50 to 200 mcg intravenously). If this intervention does not enable prompt
>delivery of the head and the fetus is viable, we suggest replacing the body
>of the fetus in the uterus before proceeding to cesarean delivery (Grade
>2C<http://www.utdol.com/utd/content/image.do?imageKey=requ_pix/grade_13gif>)
>(see "Head entrapment"
>above<http://www.utdol.com/utd/content/topic.do?topicKey=pregcomp/17267&view=print#9>).
>Lyndon Taylor MD
>Oak Park, Illinois
>> ----- Original Message -----
> From: GIN11153@aol.com<mailto:GIN11153@aol.com>
> To: Multiple recipients of list OB-GYN-L<mailto:ob-gyn-l@dns.obgyn.net>
> Sent: Saturday, September 02, 2006 1:23 PM
> Subject: Policy needed for Nitroglycerine for head entrapment
>
> Does anyone have a policy to share? We had a 25 weeker demise that
>delivered breech this past week and head became entrapped. Staff and doctor
>didn't know about giving IV nitro but I had learned about it over a year
>ago on a legal case.
>
> Gail Neuman RNC CPHW SNP LNC
> student nurse practitioner and student midwife
> listowner of LegalNurseConsulting@yahoogroups.com
> certified high risk OB/legal nurse consultant
> Perinatal Nurse Associates
> Notary Public/Certified Loan Signing Agent
> PrePaid Legal Sales Associate
> Santa Ana, CA
