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COTW SMNET Catch of the week 16/1/12

Discussion in 'Catch Of The Day' started by iolaus, Jan 16, 2012.

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  1. Penguin Moderatorgator

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    Sorry that was to someone saying the bp isnt high, but booking bp has already been mentioned so feel free to ignore me
    Penguin, Jan 17, 2012
    #21

  2. iolaus Education Moderator

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    Fern appears relaxed and when you ask if she wants pain relief she asks for a paracetamol
    Give Fern paracetamol (1g) and ranitidine (150mg)
    Check her BP 120/80, P 82.
    Wonder about the raised BP and check notes – no history of raised BP including this morning (a single episode of 140/85 at 35 weeks is the highest, and booking BP was 120/75). Fern was booked for obstetric led care for raised BMI.
    iolaus, Jan 17, 2012
    #22

  3. Sunny Well-Known Member

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    So we now know the booking bp so the current bp is ok?

    Perhaps VE to check dilation, how many hours since last now? I'm unsure now why she was ambulanced in? What's her BMI? Is there is different pathway for women with a very high BMI?
    Sunny, Jan 17, 2012
    #23

  4. Penguin Moderatorgator

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    I'm confused I thought she had 'raised blood pressure' ?

    Just curious what is her BMI :)
    Penguin, Jan 17, 2012
    #24

  5. iolaus Education Moderator

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    about 40 - the phone call we got was that she was a raised BP lady, she wasn't (and no I don't know why she was ambulanced in either)
    iolaus, Jan 17, 2012
    #25

  6. Mush Well-Known Member

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    Subscribing.
    Mush, Jan 17, 2012
    #26

  7. Sunny Well-Known Member

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    Strange she was sent in so urgently then. Do another set of obs but if she is still at 3cm and all else is well send her home and to call again when she is contracting 3 in 10?

    Maybe do the bloods just to rule out pre-eclampsia (how quick is that?)

    Is there a chance she was ambulanced in because she has no support?
    Sunny, Jan 17, 2012
    #27

  8. wannabamidwife New Member

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    Some thing is making me think that community midwife sent her in because she needed obstetric care during deliver due to raised BMI so when she VE's and found Fern to be 3cm she must have thought by the time she gets to a hospital she will be 4cm? Therefore pathway needing to be started, maybe she called ambulance because Fern had no other transport in? If she was to be sent home from clinic and then went into established labour with no one around or something happened then she would have to have called the ambulance anyway?

    Maybe ambulance control heard wrong information??? Raised BMI might have been heard as raised B and then the operator just thought it was raised BP?? miscommunication?
    wannabamidwife, Jan 17, 2012
    #28

  9. Penguin Moderatorgator

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    Arent they meant to call a taxi instead of an ambulance if its not an emergency though?
    Penguin, Jan 17, 2012
    #29

  10. wannabamidwife New Member

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    If it is just a trace of blood that is heamolised then I wouldnt be worried... the protein trace could be worrying but in the absence of a raised BP and any other signs of pre-eclampsia I would suggest that we leave Fern to rest and get on with moving into established labour, giving her the support she needs to keep mobile and use the toilet with support if needs be. Sometimes protein can be seen if there is an infection present but Ferns temperature doesnt seem feverish...
    I would want to keep an eye on her and do another dipstick next time she wants to urinate. Make sure she keeps her fluid levels up to prevent dehydration.
    wannabamidwife, Jan 17, 2012
    #30
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