Re: Policy needed for Nitroglycerine for head entrapment
From: art fougner, md (evsono@pipeline.com)
Sun Sep 3 18:06:27 2006
Why not simply use amyl nitrite inhalation?
Art
At Sun, 03 Sep 2006, Andrew Folley wrote:
>
>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
>
--
art fougner, md
"May The Wings of Liberty Never Lose a Feather." - Jack Burton
