The Journal of perinatal & neonatal nursing
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J Perinat Neonatal Nurs · Apr 2012
Advanced cardiovascular life support for the obstetric population: bridging the gap.
The International Liaison Committee on Resuscitation advocates for rapid implementation of critical interventions to provide the best chance of survival for patients experiencing a cardiac arrest. Standard educational programs do not include population-specific interventions or modifications. This article provides information regarding how to use an established Advanced Cardiovascular Life Support program as the foundation on which to build a population-specific course. The purpose of creating this blended program is to meet the learning needs of the obstetric healthcare provider and standardize care across all settings, particularly in the perioperative and postanesthesia areas.
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Cardiac arrest in pregnancy is a rare event, and the speed of resuscitation response is critical to the outcome of both the mother and the fetus. The management of the unresponsive pregnant woman differs from that of the traditional adult resuscitation. In this article, causes of maternal arrest, management of proper cardiopulmonary arrest in pregnancy, and implementation of perimortem cesarean delivery are discussed.
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J Perinat Neonatal Nurs · Jan 2012
Oxytocin administration: the transition to a safer model of care.
The use of oxytocin, a high-alert medication, has increased dramatically in recent years as induction rates have risen. Methods for administration of oxytocin and subsequent outcomes have long been a source of debate. Furthermore, one of the leading causes of obstetrical liability claims involves the administration of oxytocin leading to tachysystole. ⋯ The goal of this initiative was to decrease risk exposure by successfully implementing a standardized evidence-based protocol and processes across the healthcare system. There has been implementation of standardized oxytocin mixtures, low-dose administration guidelines, and safety checklists to assure fetal and maternal well-being before initiation of oxytocin and increases in oxytocin dosages. The associated outcomes after this initiative have been shorter lengths of labor, decreased incidence of tachysystole, and decreased incidence of primary cesarean birth.