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OB: clinic protocol for eclampsia From: David Hunter (hunter.d@ghc.org) Wed Dec 31 20:34:52 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: DRoss38040: "Re: Prenatal Rituals" Previous message: David Hunter: "GYN: bleeding after ablation" 18 yr old at 29 weeks with no prior indication of PIH or seizure disorder, seen as walk-in for nausea, vomiting and facial rash, seizes as soon as she is put in an exam room. question: appropriate immediate management once seizure ends. Options: Put in IV and administer IV MG bolus (of course, clinic nurses not as IV-skilled as hospital nurses and though the mag is on a crash cart just down the hall, nursing staff not totally comfortable with pushing IV mag IM mag, just like we did 15 years or so ago put her on a stretcher, go down one floor elevator, across a sky bridge to hospital, then down another floor, then around corner to L&D (with level III nursery) call 911 who will send ambulance to take her to ER around the corner and then to L&D (seems ludicrous but come adminstrators like this idea, wanting to shift responsibility to someone else as soon as possible--what if she seizes again in the elevator and aspirates, they say) or any combination of the above. on L&D: serum studies all normal except 7.2 uric acid, low output, flat FHTs. Cervix 2/50%. we started betamethasone, vitramin K, cytotec (2/50%), with immediate contractions but persistent late decels, so low transverse C/S. baby: female, 1010 grams, now 9 days old on nasal cannula and increasing tube feedings comments? Next message: DRoss38040: "Re: Prenatal Rituals" Previous message: David Hunter: "GYN: bleeding after ablation"

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