10-27-2009, 08:36 AM
CCS eclampsia any one?
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ccs eclampsia - acha
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10-27-2009, 11:46 AM
let me try
Location ER order pulse oxy oxy inhalation iv access bp monitor cardiac monitor fetal heart monitor Focus P/E,HEENT,Heart and Lung, Abdomen, genitalia, Neuro, extremity Order MgSo4 iv continous Labetalol iv or hydralazine i/v iv NS NPO pt/ptt cbc bmp lfts UA BUN/Cr serum mg obstetric consult for immediate delivery by c section hopefull the case will end here if not advance clock to get reults continous monitoring of proteinuria vitals esp bp q 1hr serum mg if gestation
10-27-2009, 05:02 PM
you could add type and cross, rh type
and isn't BUN/Cr part of BMP? how about an ultrasound?
10-27-2009, 07:50 PM
1 Magnesium sulfate iv bolus is administered to prevent and treat subsequent seizures in women with eclampsia. Give bolus followed by a maintenance dose as a continuous iv infusion.
2 Additional seizur after receiving magnesium sulfate will be treated as status epilapticus a phenobarbital iv b lorazepam IV (may repeat the dose in 5-15 min) or c diazepam IV (may be repeated every 15 min ) both as per protocol for status epilepticus.
10-27-2009, 09:59 PM
hmm maybe to monitor mg toxicity
serum mg 2 hrly foley cath and urine output and stuff like s uric acid, d dimer, fibrinogen, rh type maybe?????? and cant we deliver by ordering iv oxytocin cont and delivery??? or do we need to go for CS?
10-28-2009, 05:52 AM
good points navz! we needs to monitor all those
i think we can go either way either iv oxytocin and vag delivery or c section with obs consult.
10-28-2009, 06:12 AM
¢ History of pre-Eclampsia and patient is having seizure. It can happen upto 6 weeks post partum.
¢ Manage ABC--> airway, IV access, routine blood, Foleys catheter ¢ Seizure control: Loading dose of MgSO4 4gm or Diazepam 5-10mg over 4 minutes or until seizure stops. ¢ Continuous IV MgSo4 2-3gm/hr. ¢ Magnesium blood level is checked very 4-6 hours. (Therapeutic level--> 4-6meq.L) ¢ Control the hypertension (Hydralazine or Nifedipine, labetolol), ¢ Urine output. ¢ Labs: Routine urine, CBC, chem8, PT, PTT, blood for grouping and cross matching, LFT ¢ Deliver the baby by either induction or Consult the obstetrician and CS. |
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