Emergent blood transfusion
Assume you have a G5P4 with a previously undiagnosed placenta percreta. She has not had routine prenatal care. She presents urgently to L&D in labor and the OB/GYN calls for a stat C-section. You send a type/screen/cross and proceed to the OR. Intraoperatively, she begins to bleed and sag. You call for blood and the blood bank tells you the patient is A+ but they have detected antibodies on screen. The donor samples they have crossed so far have all been positive and the risk of an... Emergent blood transfusion (Source: Student Doctor Network)
Source: Student Doctor Network - May 5, 2019 Category: Universities & Medical Training Authors: AnesThrowaway Tags: Anesthesiology Source Type: forums

Some more clinical questions pt.2
Thanks to all who replied to my previous thread. I learned a lot from your different perspectives. Here's another set of questions from issues I've encountered: How do you deal with timing of different antibiotics peri-operatively? For example: pregnant female comes in for a C-section. She gets penicillin G q4h, then cefazolin once for incision, then ampicillin q6h postpartum for... Some more clinical questions pt.2 (Source: Student Doctor Network)
Source: Student Doctor Network - May 4, 2019 Category: Universities & Medical Training Authors: GravityBeetle Tags: Pharmacy Source Type: forums

Dose up Labor epidural or perform new spinal for C-section
25 year old female patient with a labor epidural. Obstetrician decides that she has been stuck at 7 cm long enough and a C-section should be performed for failure to progress. Do you dose up your labor epidural to a C-section level? Or do you instead remove the epidural and perform a new spinal? I will leave the question as this, as I do not want to color the responses with my baggage. (Source: Student Doctor Network)
Source: Student Doctor Network - April 14, 2019 Category: Universities & Medical Training Authors: Impromptu Tags: Anesthesiology Source Type: forums

C-section meds choices with spotty epidural
Hey guys, CA1 here. I just wanted to get your thoughts on how you would approach a spotty epidural during C-section? What I've been doing is obviously re-dose epidural with 2% lido + epi (+/- fentanyl) up to 20cc, then I would go to 3% chloro. From here, I've had attendings do many different things. Most of them start working in some ketamine (10mg a time), some give midaz, rarely give IV fentanyl (until the baby is out). I was also wondering, is there any specific contraindication to... C-section meds choices with spotty epidural (Source: Student Doctor Network)
Source: Student Doctor Network - April 26, 2018 Category: Universities & Medical Training Authors: whiteorgo Source Type: forums

High K+, pre-renal
I had something happen in a case the other day that I don't think I have seen in a long time, if ever. Case - 39 y/o Post-partum s/p C-section- bleeding into abdomen. Patient had slightly elevated creatinine. Hgb - ~7. She had pre-elampsia (I don't know how severe) and was on Mg+. She gets rushed to the OR. Upon arrival she was mildly tachycardic, very hypertensive, and obtunded but arousable. On her EKG, I thought it looked like peaked T's but wasn't suspecting elevated K at that... High K+, pre-renal (Source: Student Doctor Network)
Source: Student Doctor Network - April 7, 2018 Category: Universities & Medical Training Authors: epidural man Source Type: forums

Hyperbaric bupivicaine shortage
Hyperbaric bupi on shortage. Considering isobaric bupi or tetracaine for single shot spinal for c section. Anybody else been in this situation of drug shortage and what did you do? Sent from my iPhone using SDN mobile (Source: Student Doctor Network)
Source: Student Doctor Network - March 2, 2018 Category: Universities & Medical Training Authors: MCG2012 Source Type: forums

Magnesium C section
hi folks. had a patient with gestational hypertension (no evidence of proteinuria) who had Mg running as per OB service. pt was brought to the OR for fetal intolerance/decels. spinal was placed and by this time i had stopped the Mg infusion since i didn't think pt had preeclampsia and there was no need for seizure prophylaxis. anyways the OB was not happy i had stopped the infusion and told me that the patient was still high risk for seizures. i know this is true for pre-eclamptics but... Magnesium C section (Source: Student Doctor Network)
Source: Student Doctor Network - January 18, 2018 Category: Universities & Medical Training Authors: jeesapeesa Source Type: forums

What are your thoughts on opioid prescriptions for kids/adolsecents?
I am just wondering what are your thoughts and experience with seeing these type of prescriptions? As long as the dose matches up with the dosing regiment on say lexicomp, do you question the dose any further? Any particular drugs you deny, besides say codeine/tramadol formulations? One last question to add, I have looked this up and it seems to be the norm, but i am just wondering to be sure. Have you all seen Percocet/Norco while breast feeding, especially after say c-section or after... What are your thoughts on opioid prescriptions for kids/adolsecents? (Source: Student Doctor Network)
Source: Student Doctor Network - December 12, 2017 Category: Universities & Medical Training Authors: nsansom15 Source Type: forums

Repeat c-sections and "failed" spinal
Did a spinal anesthetic (1.7cc 0.75% bup + 5mcg fent + 250mcg morph) recently, went in as easy as any other spinal I've done for a c-section. This lady was having her 4th c-section. Surgeon tested with aliss and pt felt nothing; and no response to incision either but once theyre inside working to get baby out, she starts moaning and squirming her shoulders around and when I inquire she insists that she feels pressure, not pain. Remainder of the surgery is pretty much the same, especially... Repeat c-sections and "failed" spinal (Source: Student Doctor Network)
Source: Student Doctor Network - October 26, 2017 Category: Universities & Medical Training Authors: leaverus Source Type: forums

What happened to the s at c section thread
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Source: Student Doctor Network - September 2, 2017 Category: Universities & Medical Training Authors: JobsFan Source Type: forums

Stat C section
I am a novice when it comes to stat C sections but I am wondering whether at your institutions/practices, sometimes the OB starts cutting without asking the anesthesiologist? Is this a thing in OB? Obviously from our perspective, the 1st concern is safety of the mother. The patient in case I recently did had a running epidural for labor, but barely received any additional local anesthetic for surgery before they cut, said 'ow' when they started cutting but luckily didn't jump off the table.... Stat C section (Source: Student Doctor Network)
Source: Student Doctor Network - September 1, 2017 Category: Universities & Medical Training Authors: waterbottle10 Source Type: forums

C section for breech...timing of confirmation of breech?
Hi, I'm an anesthesiologist in Canada...I had a patient booked for primary section for breech. Their last ultrasound was 2 weeks ago. The surgeon palpated the fetuses position, and although they didn't seem 100% sure, felt the baby was still breech..(he wasn't, which was evident during the c section) This made me wonder: Are there any clear guidelines about confirmation of breech position prior to C section for breech? eg. should an ultrasound have been done day of? or is palpation... C section for breech...timing of confirmation of breech? (Source: Student Doctor Network)
Source: Student Doctor Network - August 4, 2017 Category: Universities & Medical Training Authors: lgher Source Type: forums

LMA supreme for elective C-section
What are your thoughts on this? An old timer I knows says doing sux, lma, immediate placement of the OG down the supreme, if no return (which he said only happened a few times over decades) then he'll ventilate shortly and intubate. He swears by it. I've heard of the technique for light paralysis in healthy patients with 30 minute lap-chole surgeons from a few guys from europe. (Source: Student Doctor Network)
Source: Student Doctor Network - July 28, 2017 Category: Universities & Medical Training Authors: Maverikk Source Type: forums

Cracking up
My husband is doing his clinical rotations three hours away. I am living with my mother with our three month old daughter. We have no money and have to pay for him to live with a roommate close to the hospital. He is spending money like crazy and has developed a bad reputation at this rotation for not showing up and being late. Every other day he is making me log in to his school send emails deal with his loan payments put out his fires all while recovering from a c section and now a slipped... Cracking up (Source: Student Doctor Network)
Source: Student Doctor Network - May 28, 2017 Category: Universities & Medical Training Authors: Done34 Source Type: forums

They want me to be an RN
Greetings, I AM CONFUSED AND STARTING TO GET DEPRESSED... I am a secretary at a hospital in Atlanta. I've been working here for 2.5yrs now. My goal is to become an OBGYN I am very passionate about women's health. I don't see myself doing anything else for the rest of my life. I was able to shadow an M.D for a day and I witnessed a c-section with tubal ligation. That was the day that REALLY solidified my dream. Here is my dilemma, I'm 21 and I'm not getting any younger. I don't have a... They want me to be an RN (Source: Student Doctor Network)
Source: Student Doctor Network - May 20, 2017 Category: Universities & Medical Training Authors: aspiringMD585 Source Type: forums

OB Case
I do quite a bit of OB calls and had this come up a few times. The attendings in my group are mixed in their management of this situation, so maybe some of you OB experts can help. Here's the situation: Laboring patient comes into the hospital and for one reason or another needs an urgent C-section. The problem is she had a full meal (McDonalds or a steak) a few hours prior to this. The OB wants to do the case under a spinal. I tell them no, the patient is not NPO and if we're going now,... OB Case (Source: Student Doctor Network)
Source: Student Doctor Network - February 26, 2017 Category: Universities & Medical Training Authors: RussianJoo Source Type: forums

C-section vs vaginal birth
seeing how its been almost 10 years since my ob-gyn rotation, i was just wondering if there has been any updates with respect to recommendations between elective c-section vs vaginal birth. how do you approach a patient who asks about the 2 ? thanks (Source: Student Doctor Network)
Source: Student Doctor Network - February 10, 2017 Category: Universities & Medical Training Authors: obiwan Source Type: forums

WTF...PA students = Medical students?!?!
I wanted to scrub in on a C-section today and was snubbed by the OB resident in favor of a PA student (I almost hit her with "I didn't realize PA's were doing C-sections now," but thought better). A few days ago, I was reamed out for having the audacity of trying to observe a birth without introducing myself to the patient first. No problem, my bad -- I wasn't aware of L&D etiquette and now make it a point to establish some kind of relationship with everybody on the floor first thing in... WTF...PA students = Medical students?!?! (Source: Student Doctor Network)
Source: Student Doctor Network - December 14, 2016 Category: Universities & Medical Training Authors: Back34 Source Type: forums

OB Case: What would you do?
On call the other night and get a call from OB resident at 2am that there is a patient that was scheduled for a C-section the upcoming day for 7:30am. PAtient had come to OB office that afternoon due to feeling contractions around 4PM. In office patient was found to be 3cm and sent to hospital for observation, ultrasound and cerv exams. So at 2:30AM patient with increasing contractions and found to be 5cm, so they wanted to go ahead and do the section. When I asked why the patient was... OB Case: What would you do? (Source: Student Doctor Network)
Source: Student Doctor Network - October 5, 2016 Category: Universities & Medical Training Authors: sigrhoillusion Source Type: forums

c-section case
30 y/o 200lb Mallanpati #3 patient with high anxiety, fibromyalgia with multiple psych issues who has had a localized allergic reaction to lidocaine (says she had a raised red rash on arm from iv start with lidocaine). wants a general anesthetic for repeat c-section. (1st c-section was under general due to failed epidural- no anesthetic record available). Pt convinced to have spinal. No immediate reaction to lidocaine sq. 2 passes of spinal needle patient starts crying saying to stop... c-section case (Source: Student Doctor Network)
Source: Student Doctor Network - August 29, 2016 Category: Universities & Medical Training Authors: KungPOWChicken Source Type: forums

OB Case
I do quite a bit of OB calls and had this come up a few times. The attendings in my group are mixed in their management of this situation, so maybe some of you OB experts can help. Here's the situation: Laboring patient comes into the hospital and for one reason or another needs an urgent C-section. The problem is she had a full meal (McDonalds or a steak) a few hours prior to this. The OB wants to do the case under a spinal. I tell them no, the patient is not NPO and if we're going now,... OB Case (Source: Student Doctor Network)
Source: Student Doctor Network - June 29, 2016 Category: Universities & Medical Training Authors: RussianJoo Source Type: forums

How soon can I go for placement after C Section?
Forum: Nursing and Midwifery Posted By: Mimi2014 Post Time: 13-04-2016 at 21:41 (Source: The Student Room)
Source: The Student Room - April 13, 2016 Category: Universities & Medical Training Source Type: forums

C section v natural birth
Hi All I am 8 weeks pregnant with my second child and am 31 years old with an average FEV1 of 70%. My CF team have told me that all their pregnant CF ladies get delivered by C section. I am not very happy about this as I really wanted a natural delivery. I had a child 10 years ago and had a natural delivery then, and there were no problems with my lungs. Then my FEV1 was about 80%. But I had that child at a different CF centre. I read up on the net and was surprised to see that lots of CF ladies said they had been advised AGAINST a C section because of increased recovery time and strain on the stitches when coughing... ...
Source: Cystic Fibrosis Pregnancy Forum - September 23, 2013 Category: Respiratory Medicine Authors: dtc1982 Tags: Pregnancy Source Type: forums

What would you do?
I'll post a case from my last night on call since the forum is dead. RN calls me at 10:00 PM to come see ICU pt for respiratory distress. Get to the bedside 10 min later. Morbidly obese WM (50'ish) with RR low 40's sitting upright in bed. Pulse 115, afib BP 80/40's by radial A -line spO2 89% on NRB Weight 425 lbs massive subq air extending up to head Head shape/size of a pumpkin Can not open eyes due to subq air in eyelids Awake and will follow commands but not talking Can open his mouth about 1.5 inches Quick update by RN: POD #3 from CABG, EF 45 % pre-op Extubated POD #1 Still on dobutamine for lowish CI (has triple...
Source: Student Doctor Network Forums - July 27, 2013 Category: Universities & Medical Training Authors: bigtuna Tags: Critical Care Source Type: forums