Epidural Request with Cook/Foley Balloon still in place

[DocNukem2004]

Curious how people typically respond to requests for labor epidurals on patient undergoing induction and still have the Cook/Foley balloon in place, are people typically more agreeable or hesitant too early on in the process?

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[dmk5n]

just stick it in.

 

[sevo00]

Honestly never cared to look

 

[Pharmado]

That’s the obstetric departments job to decide if they are ready. I’m not doing cervical exams so I’ll have to trust their judgement on that.

 

[Anestheezee]

As long as they aren't planning to discharge before delivery they can get it whenever they want as far as I'm concerned. They just have to know they can't eat, have to be hooked up to all the stuff, and have to be straight cath'd.

 

[PainDrain]

The new ACOG standards have forced our hand. Lady shows up at 10cm and is demanding an epidural. Do it!!! Lady shows up at 1cm and baby high. Do it!!! Lady has gas pains and just happens to be pregnant. Do it!!!


I was asked to place an epidural in a woman who wasn’t in labor but due to severe psychosocial issues could not be examined to see if she was in labor. I did it, albeit reluctantly.

 

[Anestheezee]

The new ACOG standards have forced our hamd. Lady shows up at 10cm and is demanding an epidural. Do it!!! Lady shows up at 1cm and baby high. Do it!!! Lady has gas pains and just happens to be pregnant. Do it!!!

I would just replace your "Do It!" with "Get it over with!" 😀

 

[Pharmado]

The new ACOG standards have forced our hand. Lady shows up at 10cm and is demanding an epidural. Do it!!! Lady shows up at 1cm and baby high. Do it!!! Lady has gas pains and just happens to be pregnant. Do it!!!


I was asked to place an epidural in a woman who wasn’t in labor but due to severe psychosocial issues could not be examined to see if she was in labor. I did it, albeit reluctantly.

Severe psychosocial issues, probably not in labor, probably doesn’t have insurance and isn’t paying for the care. Sounds like a dream come true.

 

[anonperson]

Curious how people typically respond to requests for labor epidurals on patient undergoing induction and still have the Cook/Foley balloon in place, are people typically more agreeable or hesitant too early on in the process?

Why would it matter if it's early in the process?

The cervical ripening balloons are effective but fairly unpleasant. They are physically stretching the cervix to nearly 4 to 5 cm. Kind of barbaric but it works.

I have asked patients if they want an epidural before I placed a cook catheter in order to make it easier on them ( and myself).

 

[pocafx]

Just do it and then complain how stupid everyone else is in the lounge

 

[GassYous]

Just do it and then complain how stupid everyone else is in the lounge

Sounds like my residency program

 

[PainDrain]

Sounds like my residency program

Wonder if we trained at the same place or if that is universal.

 

[pocafx]

I think it’s universal. The lounge is anesthesia safe space lol

 

[dumbmedstudent]

I don’t like placing epidurals that early, especially for nulltips. When they are placed so early I feel like it increases the likely hood of the epidural being patchy later or straight up malfunctioning. I think it’s better to wait till >3-4 cm

 

[Gasworks]

Just do it and then complain how stupid everyone else is in the lounge

Literally sums up 90% of my day in a nutshell. I’m putting this on a tshirt and wearing it under my scrubs.

 

[Urzuz]

just stick it in.

That’s how the patient ended up in this mess to begin with

 

[Hoya11]

Why would it matter if it's early in the process?

The cervical ripening balloons are effective but fairly unpleasant. They are physically stretching the cervix to nearly 4 to 5 cm. Kind of barbaric but it works.

I have asked patients if they want an epidural before I placed a cook catheter in order to make it easier on them ( and myself).

Bigger issue is RNs advising waiting too long than too early

 

[DocVapor]

I'll place an epidural as early as they want, I just will tell them that it's hard to know for sure it's in the right place because there's no clear "Pain was a 15 but now I want to marry you." Also I won't do a loading dose, I'll just start the pump and maybe hit the button once for them as a demonstration if I'm feeling inclined towards a little extra "customer service" that day.