This is such a poor excuse because you are hopefully not inserting the
thermometer far enough to prove that the baby has a continuous gut with
no obstructions. The only proof of this is passage of meconium.
Baby's that have meconium ileus will have perforate anus' but still
have a obstructed bowel. I too have picked up a imperforate anus that
was missed by 48 hours worth of midwives looking after a baby but I
didnt need ot attempt to put a thermometer up his bum to tell I just
needed to look. Recently we had a baby with very delayed passage of
meconium and sometimes this can be stimulated by insertion of a rectal
thermometer but I chose instead to give the baby a bit of anal massage
which assisted it to pass a very sticky mecoium plug which I was
surprised to hear that many of my colleagues had never seen before.
Andrea
On 24/01/2006, at 9:03 AM, sharon wrote:
at the hospital i work in the paediatrician/neonatologist inisit on
all newborns have a rectal temp done for the first temp. i have been
told when questioning this from the clinical learning co-ordinator
that there once was a baby who had a imperferated anus and this was
not picked up until too late and the baby became very sick so it is
protocol. also i was told that there is a difference in temperature as
when i looked this subject up for my own interest if you take a temp
axilla there is also many other factors which come into play such as
the air temp and if the thermometer is accurately placed. the
references i cant remember but the evidence suggested that for a
accurate reading we should be taking temperatures rectally for infants
and orally for adults not axilla and certainly not be the fold at the
back of the newborns neck.
regards
----- Original Message ----- From: "brendamanning"
<[EMAIL PROTECTED]>
To: <ozmidwifery@acegraphics.com.au>
Sent: Tuesday, January 24, 2006 12:11 AM
Subject: Re: [ozmidwifery] IV Synto for 3rd stage
How amazing, rectal temps are so archaic !
I thought they went out with PR exams to assess dilation.
Poor you !
Keep questioning, that's how change
happens............................eventually.
With kind regards
Brenda Manning
www.themidwife.com.au
----- Original Message ----- From: "Kylie Holden"
<[EMAIL PROTECTED]>
To: <ozmidwifery@acegraphics.com.au>
Sent: Monday, January 23, 2006 11:42 PM
Subject: Re: [ozmidwifery] IV Synto for 3rd stage
All debates regarding active v. physiological third stage aside, I
was referring to women who have had a jelco put in for whatever
reason (IV antibiotics in labour, epidurals, etc).
I completely agree with you Brenda, that the number of women who
didn't get their "required" dose of synto and who go on and have a
(semi) physiological third stage are evidence in favour of safe,
"normal" 3rd stage. Unfortuately this particular hospital doesn't
take too kindly to students coming in and questioning their
protocols! We learnt that the hard way when we (as students) tried
not to take babies first temps rectally...a protocol was soon put in
place that this MUST occur!
Kylie
From: "brendamanning" <[EMAIL PROTECTED]>
Reply-To: ozmidwifery@acegraphics.com.au
To: <ozmidwifery@acegraphics.com.au>
Subject: Re: [ozmidwifery] IV Synto for 3rd stage
Date: Mon, 23 Jan 2006 15:18:48 +1100
Kylie,
We are presuming these are all high risk women you are dealing with
as otherwise there would be no need for her to have a jelco in
place ?
I am including women who have epidurals in this category as this
automatically makes them high risk once they've deviated from the
'body driven' course of labour.
Otherwise...............
Why would a low risk woman :
a. have a jelco in situ during labour ?
b. need an oxytocic ?
So assuming she is high risk you need to be very sure she gets the
oxytocic, she really needs it as her body has had its input
overridden by the initial intervention so it makes sense to flush
the tubing & ensure the accurate therapeutic dose is received.
Maybe you might put some thought out there in your workplace about
how all those women whose MW didn't flush & they therefore didn't
actually get their synt (or got a reduced/minimal amount) managed
to have a "normal" 3rd stage & no PPHs ?
Now there's an interesting question to ask your colleagues !!
With kind regards
Brenda Manning
www.themidwife.com.au
----- Original Message ----- From: "Ceri & Katrina"
<[EMAIL PROTECTED]>
To: <ozmidwifery@acegraphics.com.au>
Sent: Sunday, January 22, 2006 6:04 PM
Subject: Re: [ozmidwifery] IV Synto for 3rd stage
Hi Kylie
we actually give 5IU synto diluted in 10mls Normal saline, then
flush that through with a flush.
In the short time I have been in Middy even when we gave it not
diluted, it was still flushed.
katrina ;-)
On 22/01/2006, at 2:20 PM, Ken WArd wrote:
Proberly where it should sit for a normal birth. But when it is
advisable to
give synto, then I guess you should flush the line.
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] Behalf Of Kylie
Holden
Sent: Sunday, 22 January 2006 12:14 PM
To: ozmidwifery@acegraphics.com.au
Subject: [ozmidwifery] IV Synto for 3rd stage
Hi all
I'm a Mid student (who has finally finished all her birth
requirements...yay!) and this issue has only just come up for me
over the
last week or two. For the first time in two years, a midwife I
was working
with pointed out the importance of flushing through the synto if
you have
given it IV, if there was no drip running to flush it through.
This obviously makes sense, because if you don't flush it, the
synto will
just sit in the J loop or IV line. However, I had never actually
seen a
midwife do this before. Over the next few days I asked a few
midwives what
they do, and the responses I got ranged from "Why on earth would
you need to
do that?" to "Yes, of course you need to flush it!"
Any thoughts on this topic?
Kylie
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