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Re: Vacuum extraction privileges for CNMsFrom: Andrew Folley (agfolley@hotmail.com)Sat Jun 16 15:57:51 2007
>From: "R. Daniel Braun" <rd.braun@gmail.com> >Reply-To: ob-gyn-l@obgyn.net >To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> >Subject: Re: Vacuum extraction privileges for CNMs >Date: Fri, 15 Jun 2007 21:48:12 -0500 > >It is an operative vaginal delivery and requires as much skill as applying >forceps does. Do you want CNM's doing forceps? or C/S??? that would be >next. > >Dan > >On 6/15/07, Tom and Elizabeth Johnston <yesallours@nc.rr.com> wrote: >> >> Is it the standard of care for CNMs to have vacuum extraction >> >>privileges? : As Susan said, it is an extra skill the senior CNM can >>learn based on practice needs. >> >>What is the policy at your institution/practice?: At our facility we can >>learn VAVD if we desire. About ½ of our CNMs do them and the others do >>not. >> >>What are your thoughts? I have very little use for VAVD. Of the last 250 >>deliveries in my facility that I've attended, I've needed operative >>vaginal >>delivery only 5 times ( 2 forceps, 3 VAVD). The few times I've "needed" >>help getting a baby out there was always been a resident readily available >>that needed the experience more than I do. I have been tempted to use >>vacuum more often but since I didn't have it readily available I didn't >>bother. My philosophy has always been "judicious use of technology." If >>I >>don't absolutely have to intervene I won't. >> >>Do I think CNM's Can or should use vacuum? In an isolated environment it >>can be a very useful skill in a pinch. In a big busy practice (mine is 12 >>CNM, 12 OB/GYN and we deliver 240-300 / month) where there is 24/7 OB >>access >>there is very little need for a CNM to learn the skill. >> >>Tom Johnston >> >>CNM, IBCLC >> >>Fort Bragg, NC >> >agree it is an operative delivery. Disagree that it requires as much skill >as using forceps. > >-- >R. Daniel Braun, MD FACOG(L) CMT >Professor Emeritus >Dept. of Obstetrics and Gynecology >Indiana U. School of Medicine > >R. Daniel Braun > > "Science without Religion is LAME; Religion without Science is >BLIND" > Einstein 1941 Ag
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