Re: [ozmidwifery] wasIV Synto for 3rd stage now rectal temps
I'm afraid so... I don't actually work there, these are experiences as a student. Not sure if the hospital I'm talking about is the same as Sharon's, but the story is the same. Kylie From: Alesa Koziol [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] wasIV Synto for 3rd stage now rectal temps Date: Tue, 24 Jan 2006 18:37:03 +1100 Please be assured that I am not killing the messanger here...but really, are you really telling me that at your site all newborn infants are subjected to an invasive process because once upon a time a single baby had a problem? Alesa - Original Message - From: sharon [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, January 24, 2006 9:03 AM Subject: Re: [ozmidwifery] IV Synto for 3rd stage 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 happenseventually. 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
Re: [ozmidwifery] wasIV Synto for 3rd stage now rectal temps
I think it's called a'blanket policy'! Rationale: so that nobaby 'slips through the cracks' !! Just like Konakion, Syntocinon, LUSCS for Breech. Much less time consuming than actual risk assessment. Need I go on ? With kind regardsBrenda Manning www.themidwife.com.au - Original Message - From: Alesa Koziol To: ozmidwifery@acegraphics.com.au Sent: Tuesday, January 24, 2006 6:37 PM Subject: Re: [ozmidwifery] wasIV Synto for 3rd stage now rectal temps Please be assured that I am not killing the messanger here...but really, are you really telling me that at your site all newborn infants are subjected to an invasive process because once upon a time a single baby had a problem? Alesa - Original Message - From: "sharon" [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, January 24, 2006 9:03 AM Subject: Re: [ozmidwifery] IV Synto for 3rd stage 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 stageHow 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 happenseventually. 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
RE: [ozmidwifery] wasIV Synto for 3rd stage now rectal temps
Hi all, There are other ways to handle the risk of missing an imperforate anus.I knowa case of a baby dying from meconium ileus due to cystic fibrosis.It was quite some time before it was realised that the baby had not passed meconium.That workplace now has a sticker on the baby's chart which must be completed by 24hours post birth stating whether or not the baby has passed urine or meconium, and if not, to document that a paediatrician has been notified. (I could probably get you a sample if you would like to show it to your paed.) Then if any invasive measures are taken, at least they may be justified, rather than subjecting all babies to the indignity and discomfort of having something passed into their rectum. Kind regards, Nicole. -Original Message-From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]On Behalf Of Alesa KoziolSent: Tuesday, January 24, 2006 6:37 PMTo: ozmidwifery@acegraphics.com.auSubject: Re: [ozmidwifery] wasIV Synto for 3rd stage now rectal temps Please be assured that I am not killing the messanger here...but really, are you really telling me that at your site all newborn infants are subjected to an invasive process because once upon a time a single baby had a problem? Alesa - Original Message - From: "sharon" [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, January 24, 2006 9:03 AM Subject: Re: [ozmidwifery] IV Synto for 3rd stage 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 stageHow 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 happenseventually. 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
[ozmidwifery] Mercury thermometers with rectal Temperatures!!!
Hi all, Am I assume that they are using mercury glass thermometers? Mercury Thermometers have been banned for clinical use in hospitals in Australia for about 8 years now primarily due to the OH S concerns of the mercury and where to put the waste if one breaks, as they do. It was agreed (I am not sure if it was a Federal Govt thing or State)that mercury equipment would be replaced and not used in new buildings. Of course the same has been difficult to change with syphgmometers. Many Hg ones remain. The mercury once leaked gets caught in cracks on floors and walls and emit vapours for years. We have not used a mercury thermometer for more than 9 years in the unit I am at. Unfortunately many hospitals a very slow to remove these dreadful items and remain committed to exposing workers and clients exposed to mercury. Various articles are listed with the QNU/ANF featured in the Green left articles. I suggest you contact your WH S committees to see what they are doing about the use of mercury thermometers in this way. http://abcasiapacific.com/englishbites/stories/s505290.htm http://www.greenleft.org.au/back/1996/221/221p7.htm http://www.greenleft.org.au/back/1995/212/212p15.htm http://www.nursingworld.org/AJN/2001/sept/Health.htm http://www.nursingworld.org/ajn/1999/sep/heal099b.htm http://www.ranknfile-ue.org/h%26s0702.html http://www.securityworld.com/infocenter/the-dangers-of-mercury-fever-the rmometers/ http://www.nyhealth.gov/nysdoh/environ/hsees/mercury_brochures/hscommitt ee.htm Cheers Barb -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of sharon Sent: Tuesday, 24 January 2006 8:03 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] IV Synto for 3rd stage 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 happenseventually. 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
Re: [ozmidwifery] IV Synto for 3rd stage
hi kylie re whats been chatting on about you probably were at the same hospital. large teritary. but if it is hospital protocol and you are found not to be doing the protocol then it is your job which would you prefer. regards - Original Message - From: Kylie Holden [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, January 24, 2006 10:05 AM Subject: Re: [ozmidwifery] IV Synto for 3rd stage Hi Sharon This is exactly the reason for the hospital I am referring to...there once was a baby whose imperforate anus was not picked up and baby became very sick. I wonder if it's the same hospital? As far as I am aware, the research shows that the difference in accuracy between PA and PR is so slight that is is not significant, and therefore not a compelling reason to take temps PR. What makes this hospital's protocol so ridiculous is that even if the baby has already passed mec, we still have to do it PR! Even though they claim the only reason we must do it PR is to check for imperforate anus. In regards to the synt, I just remembered that I cared for two women only last week (still as a student!) who had had their dose of synto (one IM and the other IV that was flushed) and they both went on to have PPHs anyway. Makes you wonder... Kylie From: sharon [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] IV Synto for 3rd stage Date: Tue, 24 Jan 2006 08:33:18 +1030 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 happenseventually. 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
Re: [ozmidwifery] wasIV Synto for 3rd stage now rectal temps
yes all babies are subjected to a once only pr temp as per the hospital protocol and as i have said before it would be negligant not to follow protocol while working at a institution. regards - Original Message - From: Kylie Holden [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, January 24, 2006 6:40 PM Subject: Re: [ozmidwifery] wasIV Synto for 3rd stage now rectal temps I'm afraid so... I don't actually work there, these are experiences as a student. Not sure if the hospital I'm talking about is the same as Sharon's, but the story is the same. Kylie From: Alesa Koziol [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] wasIV Synto for 3rd stage now rectal temps Date: Tue, 24 Jan 2006 18:37:03 +1100 Please be assured that I am not killing the messanger here...but really, are you really telling me that at your site all newborn infants are subjected to an invasive process because once upon a time a single baby had a problem? Alesa - Original Message - From: sharon [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, January 24, 2006 9:03 AM Subject: Re: [ozmidwifery] IV Synto for 3rd stage 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 happenseventually. 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
Re: [ozmidwifery] IV Synto for 3rd stage
hi kylie re whats been chatting on about you probably were at the same hospital. large teritary. but if it is hospital protocol and you are found not to be doing the protocol then it is your job which would you prefer. Regards Gee What about some lateral thinking! How about informing women about evidence and appropriate care, and giving them a choice!!! Slow in-roads to change but a least a chance of it when midwives work with women to inform and support them rather than with obstetric dominance that dictates and abuses JC -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
RE: [ozmidwifery] wasIV Synto for 3rd stage now rectal temps
Following a hospital protocol unfortunately is no protection if the protocol is wrong and you are aware. Nicole. -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of sharon Sent: Tuesday, January 24, 2006 8:20 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] wasIV Synto for 3rd stage now rectal temps yes all babies are subjected to a once only pr temp as per the hospital protocol and as i have said before it would be negligant not to follow protocol while working at a institution. regards - Original Message - From: Kylie Holden [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, January 24, 2006 6:40 PM Subject: Re: [ozmidwifery] wasIV Synto for 3rd stage now rectal temps I'm afraid so... I don't actually work there, these are experiences as a student. Not sure if the hospital I'm talking about is the same as Sharon's, but the story is the same. Kylie From: Alesa Koziol [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] wasIV Synto for 3rd stage now rectal temps Date: Tue, 24 Jan 2006 18:37:03 +1100 Please be assured that I am not killing the messanger here...but really, are you really telling me that at your site all newborn infants are subjected to an invasive process because once upon a time a single baby had a problem? Alesa - Original Message - From: sharon [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, January 24, 2006 9:03 AM Subject: Re: [ozmidwifery] IV Synto for 3rd stage 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 happenseventually. 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
Re: [ozmidwifery] Mercury thermometers with rectal Temperatures!!!
not not mercury we use digital thermometers - Original Message - From: B G [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, January 24, 2006 7:40 PM Subject: [ozmidwifery] Mercury thermometers with rectal Temperatures!!! Hi all, Am I assume that they are using mercury glass thermometers? Mercury Thermometers have been banned for clinical use in hospitals in Australia for about 8 years now primarily due to the OH S concerns of the mercury and where to put the waste if one breaks, as they do. It was agreed (I am not sure if it was a Federal Govt thing or State)that mercury equipment would be replaced and not used in new buildings. Of course the same has been difficult to change with syphgmometers. Many Hg ones remain. The mercury once leaked gets caught in cracks on floors and walls and emit vapours for years. We have not used a mercury thermometer for more than 9 years in the unit I am at. Unfortunately many hospitals a very slow to remove these dreadful items and remain committed to exposing workers and clients exposed to mercury. Various articles are listed with the QNU/ANF featured in the Green left articles. I suggest you contact your WH S committees to see what they are doing about the use of mercury thermometers in this way. http://abcasiapacific.com/englishbites/stories/s505290.htm http://www.greenleft.org.au/back/1996/221/221p7.htm http://www.greenleft.org.au/back/1995/212/212p15.htm http://www.nursingworld.org/AJN/2001/sept/Health.htm http://www.nursingworld.org/ajn/1999/sep/heal099b.htm http://www.ranknfile-ue.org/h%26s0702.html http://www.securityworld.com/infocenter/the-dangers-of-mercury-fever-the rmometers/ http://www.nyhealth.gov/nysdoh/environ/hsees/mercury_brochures/hscommitt ee.htm Cheers Barb -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of sharon Sent: Tuesday, 24 January 2006 8:03 AM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] IV Synto for 3rd stage 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 happenseventually. 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
Re: [ozmidwifery] IV Synto for 3rd stage
I have got away with carfully suggesting that there are things I have to do (because they are hospital policy) but they can always refuse if they wish ;) rgds mike On 1/24/06, Justine Caines [EMAIL PROTECTED] wrote: hi kylie re whats been chatting on about you probably were at the same hospital. large teritary. but if it is hospital protocol and you are found not to be doing the protocol then it is your job which would you prefer. Regards Gee What about some lateral thinking! How about informing women about evidence and appropriate care, and giving them a choice!!! Slow in-roads to change but a least a chance of it when midwives work with women to inform and support them rather than with obstetric dominance that dictates and abuses JC -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- My photos online @ http://community.webshots.com/user/mike1962nz My Group online @ http://groups.yahoo.com/group/PSP_for_Photographers Life is a sexually transmitted condition with 100% mortality and birth is as safe as life gets. Unknown -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] VBAC afterdehsicence or UR?
Well said Brenda On 1/24/06, brendamanning [EMAIL PROTECTED] wrote: I am not on anyones side I am not intending to be inflammatory. But I am a realist inform my homebirthing clients that should they make controversial choices ( I am a big supporter of BAC VBreech) they need to be: not intending to allocate blame if the outcome is unfavourable. It means NOT SUING the OB/MW if the outcome is poor because the client has chosen to take responsibility for her own decision-making. This doesn't make the client a victim. She made informed choices, her caregiver agreed to work with them the outcome is then the clients responsibility (barring out out negligence). When we make important decisions we are accepting the responsibility of educating ourselves about the benefits risks of a procedure then accepting the outcome as this is the consequence of our actions. It's unreasonable to blame-shift if you make a decision while fully informed then don't like the outcome. I'm not absolving health professionals of their role which is to provide a safe practice arena within their sphere of expertise. We are all accountable for our own practice. But the ever increasing litigiousness of our society is a large part of why womens choices are so reduced. I believe that compromise is the solution globally. Unfortunately there are alot of professionals consumers who won't/don't/can't discuss 'give a little to get alot'. Collaborative practice is where everyone ( health prof clients) work together for the benefit of the client. That's what we are aiming for. With kind regards Brenda Manning www.themidwife.com.au - Original Message - From: Mike Lindsay Kennedy [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Tuesday, January 24, 2006 10:49 AM Subject: Re: [ozmidwifery] VBAC afterdehsicence or UR? I like the point you make. People should be able to do it their way. And I see and hear midwives annoyance at manipulative behaviour by doctors. But I can also see it from a medical point of view. If it goes wrong the patients become victims and they and their lawyers come running looking for someone to blame. rgds mike On 1/23/06, brendamanning [EMAIL PROTECTED] wrote: Jo, I would absolutely agree with your first statement, heard it many times, got in saved/rescued your baby, just in the nick of time ! I am such a hero! With the second part: whilst very supportive of BAC I think labouring with a uterus which has already dehisced is subsequently heavily scarred is really pushing the boundaries of safety. However: as long as the mother is well informed ( being well informed means knowing the down side as well as the up side) about the risks not intending to allocate blame if the outcome is unfavourable ie a second UR ( hysterectomy etc, plus or minus a fetal death) then she can do what ever she chooses. I have seen in OT the uterus of a woman booked for a repeat EL LUSCS, not in labour, 38/40 with a dehisced area easily 5 cms in the old scar no apparent ill effects for mother or baby. Normal obs, normal CTG, normal fetal mvmts. Absolutely no sign before OT that there was anything amiss. Amazing. She had been offered BAC chose LUSCS...what if ? With kind regards Brenda Manning www.themidwife.com.au - Original Message - From: Dean Jo To: ozmidwifery@acegraphics.com.au Sent: Monday, January 23, 2006 11:15 PM Subject: [ozmidwifery] VBAC afterdehsicence or UR? not trying to be controversial (honest!) just wanting to think outside norm...how many times have I heard the story of an ob saying to a woman when giving her the repeat cs (for a 'failed vbac attempt not linked to a rupture) oh the scar was so thin it could have ripped open at any second...lucky I saved you from it. (well I am TRYING not sound too facetious) I suppose like anything we must look at rationale for the first event. IF a rupture did occur you could conclude that the repair to the uterus would be quite extensive IF she managed to not lose the uterus- hence the risks for future rupture would increase. But a dehiscence has not been proven to be a serious concern according to the investigation I have done in the last almost 9 years. There is speculation that a scar can slightly part with no harmful effects. Just asking questionsdon't they just HATE informed consumers! ;o) love Jo -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Janet Fraser Sent: Monday, January 23, 2006 8:40 PM To: ozmidwifery@acegraphics.com.au Subject: *SUSPECTED SPAM* Re: [ozmidwifery] VBAC afterdehsicence or UR? You made all my points, Jo. : ) J - Original Message - From: Dean Jo To: ozmidwifery@acegraphics.com.au Sent: Monday, January 23, 2006 8:46 PM
Re: [ozmidwifery] IV Synto for 3rd stage
Hi Justine, You're right...the issue could be worked around by offering the mother a choice by giving her the facts. Then if she doesn't consent to it you could document it as such, ie Mother did not consent to PR temp on the baby, therefore PA temp was taken or something like that. I have found this whole conversation fascinating...I have had most of my placements at two of the bigger hospitals in this state, and both insist on PR temps. It made me assume that most hospitals still had this policy, despite evidence to the contrary. OK, next big question...anyone got references off the top of their heads to support this? I promise I will do my own research (!), but if anyone knows of any articles that would be great! Kylie From: Justine Caines [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: OzMid List ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] IV Synto for 3rd stage Date: Tue, 24 Jan 2006 22:28:27 +1100 hi kylie re whats been chatting on about you probably were at the same hospital. large teritary. but if it is hospital protocol and you are found not to be doing the protocol then it is your job which would you prefer. Regards Gee What about some lateral thinking! How about informing women about evidence and appropriate care, and giving them a choice!!! Slow in-roads to change but a least a chance of it when midwives work with women to inform and support them rather than with obstetric dominance that dictates and abuses JC -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. _ Make your dream car a reality http://a.ninemsn.com.au/b.aspx?URL=http%3A%2F%2Fcarpoint%2Eninemsn%2Ecom%2Eau_t=12345_r=emailtagline_m=EXT -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
Re: [ozmidwifery] dive reflex
On 1/23/06, Ken WArd [EMAIL PROTECTED] wrote: Have you got The Midwife Companion? This book is my bible. Maureen Can you tell me the author of this book. rgds mike My photos online @ http://community.webshots.com/user/mike1962nz My Group online @ http://groups.yahoo.com/group/PSP_for_Photographers Life is a sexually transmitted condition with 100% mortality and birth is as safe as life gets. Unknown -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Injurious Practice
It is a fact that following 'policies protocols' which you know to be wrong or harmful could result in legal action by a client. You are not only condoning the action, you are accessorising it. Just following orders is how the world ended up with the Holocaust ! Both sides of the coin ! http://www.joannabriggs.edu.au http://www.usatoday.com/news/health/2001-03-14-thermometer.htm With kind regards Brenda Manning www.themidwife.com.au - Original Message - From: Kylie Holden [EMAIL PROTECTED] To: ozmidwifery@acegraphics.com.au Sent: Wednesday, January 25, 2006 9:17 AM Subject: Re: [ozmidwifery] IV Synto for 3rd stage Hi Justine, You're right...the issue could be worked around by offering the mother a choice by giving her the facts. Then if she doesn't consent to it you could document it as such, ie Mother did not consent to PR temp on the baby, therefore PA temp was taken or something like that. I have found this whole conversation fascinating...I have had most of my placements at two of the bigger hospitals in this state, and both insist on PR temps. It made me assume that most hospitals still had this policy, despite evidence to the contrary. OK, next big question...anyone got references off the top of their heads to support this? I promise I will do my own research (!), but if anyone knows of any articles that would be great! Kylie From: Justine Caines [EMAIL PROTECTED] Reply-To: ozmidwifery@acegraphics.com.au To: OzMid List ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] IV Synto for 3rd stage Date: Tue, 24 Jan 2006 22:28:27 +1100 hi kylie re whats been chatting on about you probably were at the same hospital. large teritary. but if it is hospital protocol and you are found not to be doing the protocol then it is your job which would you prefer. Regards Gee What about some lateral thinking! How about informing women about evidence and appropriate care, and giving them a choice!!! Slow in-roads to change but a least a chance of it when midwives work with women to inform and support them rather than with obstetric dominance that dictates and abuses JC -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. _ Make your dream car a reality http://a.ninemsn.com.au/b.aspx?URL=http%3A%2F%2Fcarpoint%2Eninemsn%2Ecom%2Eau_t=12345_r=emailtagline_m=EXT -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] Re: Waterbirths at Monash BC -for Pinky
Hi Pinky, I birthed at the Monash BC in May 04. I chose to birth there as I wanted a waterbirth (and didn't know what I do now about homebirth!). When it came the time i was in labour there weren't many bc midwives (7 out of 12 had quit due to the move, can't blame them) and i could only have a waterbirth with a bc midwife in attendance between the hours of 9am and 3pm. Of course i laboured at night and no longer had the option of waterbirth. I thought this may have been due to initial teething problems and lack of bc staff, but i spoke to a woman just the other day who experienced the same thing just 3 months ago. She couldn't birth in water because she had a labour ward midwife looking after her. Your daughter might want to find out when the bc midwives are actually available. It can be rather distressing if you're going through the bc only to find out that there's no staff available to attend you under that model of care! kind regards, Cate -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
[ozmidwifery] test
test. messages not getting throughis it me??? Alesa KoziolClinical Midwifery EducatorMelbourne
Re: [ozmidwifery] test
got that one... :-) Katrina On 25/01/2006, at 1:05 PM, Alesa Koziol wrote: x-tad-smallertest. messages not getting throughis it me???/x-tad-smaller x-tad-smallerAlesa Koziol/x-tad-smallerx-tad-smallerClinical Midwifery Educator/x-tad-smallerx-tad-smallerMelbourne/x-tad-smaller
RE: [ozmidwifery] Re: Waterbirths at Monash BC -for Pinky
Pinky, I supported a woman having her waterbirth at Monash about 6 months ago - it was a great experience for all, midwife was lovely and I know she is still there - I saw her during an ante-natal visit with another woman. Email me off list if you want specifics - I didn't get the initial email so I don't know what has been asked! Best Regards, Kelly Zantey Director, www.bellybelly.com.au www.toys4tikes.com.au Gentle Solutions For Conception, Pregnancy, Birth Baby Australian Little Tikes Specialists -Original Message- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Cate Tischler Sent: Wednesday, 25 January 2006 12:14 PM To: ozmidwifery@acegraphics.com.au Cc: pinky mckay Subject: [ozmidwifery] Re: Waterbirths at Monash BC -for Pinky Hi Pinky, I birthed at the Monash BC in May 04. I chose to birth there as I wanted a waterbirth (and didn't know what I do now about homebirth!). When it came the time i was in labour there weren't many bc midwives (7 out of 12 had quit due to the move, can't blame them) and i could only have a waterbirth with a bc midwife in attendance between the hours of 9am and 3pm. Of course i laboured at night and no longer had the option of waterbirth. I thought this may have been due to initial teething problems and lack of bc staff, but i spoke to a woman just the other day who experienced the same thing just 3 months ago. She couldn't birth in water because she had a labour ward midwife looking after her. Your daughter might want to find out when the bc midwives are actually available. It can be rather distressing if you're going through the bc only to find out that there's no staff available to attend you under that model of care! kind regards, Cate -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit http://www.acegraphics.com.au to subscribe or unsubscribe.
