What's in your precip pack?

[Charmie981]

I'm trying to put together a precip pack for my bag and my apprentices, as we have a few grand multips who live far away coming up.

Right now I have: instruments, 2 pair nonsterile gloves, DeLee, cord ring, 2 chux in a ziplock bag (to catch the placenta in).

Am I missing anything vital?

[mwherbs]

so a syringe and some pit

[AzariaJordan]

I think that about covers it...
I would also want towels, pph herbs/meds, and possibly resus gear of some sort.
And did I mention the towels?!
I always scope out where families keep their mixing bowls so if I get there empty handed I can quickly have cold and hot water compresses fairly quickly.

[mwherbs]

well I looked at mine and I have some 4x4 too and that is for wiping it could just as easily be anything else including paper towels---
we put the placenta in a chux

[AzariaJordan]

How about a bulb syringe or are they completely out of favor these days?

[Charmie981]

If we're gonna suction, it's gonna be something that needs a DeLee.

The pit can't stay in the precip bag because it has to go in the fridge when not in use, but I might buy some duplicates of my antibleed herbs.

[AzariaJordan]

If we're gonna suction, it's gonna be something that needs a DeLee.

:

A bit off-topic, but are there any pph meds that [I]don't[I] need to be refridgerated?

[Charmie981]

Cytotec?

I worked with a midwife who used it for pph and when I showed up at the birth, she would give it to me and say "keep this in your pocket so you have it if I ask for it." It seemed to work well for her, but I don't know if it required refrigeration or not.

[mwherbs]

I walk out the door and grab that from the fridge-- if you got gals due- little flexi- ice chest with ice pack- in car with meds--- herbs have even more of a heat stable problem because of the alcohol -- we also refresh our pit more often than the exp date because it is so hot here all the time-- here at the hospitals not refrigerated -- kept on the self--

[AzariaJordan]

I do the grab from the fridge walking out the door too, but can't if the call comes when I'm elsewhere.

That's right about cytotec, forgot about that one...as far as I know it doesn't need refridgeration.

mwherbs, I wonder if that was just an oversight on the hosp's part or if the pit actually didn't need cold temp? I worked at a clinic where it wasn't kept cold just becasue o one had bothered to look at the instructions.

[Charmie981]

Pit needs to be used in 30 days *or* kept in the fridge, so if you use a lot of it, it can go on the shelf w/o a problem. That's probably the thing with the hospital.

I keep my birth bag at the birth center/office and go pick it up before a birth, even if I have to backtrack to get back to the birth. That way I can pick up the stuff that's not normally in the birth bag (I only have one doppler and BP cuff, for example).

I use glycerin based herbs...do they have a heat tolerance issue? I've never seen herbs that said to refrigerate?

I am very anal about keeping my bag at room temperature, and not allowing it to ride around in the car, because we get REALLY hot here, too (over 100, but under 110, unlike you AZ ladies). I don't want my peri massage oil to go rancid or my gloves to melt to each other!!

[mwherbs]

it is that way at every one of the hospitals here---

you put your pit in the car when out on errands in the with - actually I carry to flexi- icechest/lunchbags-- one has my precip pack including pit-- if I walk in that bag goes with me-- first--
I prefer a bulb syringe don't like delees I think you can get as much out with a bulb as you can with a delee-- but that is my druthers-- I know some homebirth mws will take along an electric suction --

[mwherbs]

they probably use it up so fast---
from the package insert--

"Store at 2°–8°C (36°–46°F). May be held at 15°–25°C
(59°–77°F) for up to 30 days. Discard after holding at 15°–25°C (59°–77°F).

[JunipersMom]

Methergine pills dont need to be refridgerated

[Jane]

Pitocin loses 14% of it's effectiveness after 12 months at 100 F.
I wouldn't recommend Cytotec because it takes 10-20 minutes to work, unlike pitocin's 2-3 minutes.
100 F is HOT, but not "leave in the car" hot.
At 80 F, the loss is only 9% in a year. Light makes no difference.
Here's one of the sources I used in my thesis:
http://www.pphprevention.org/files/P...secure_000.pdf


I like to have a towel in the precip kit to keep the baby warm/dry them off. I've been to births where the baby's things were still in the package in the gift bags from the shower - no blankets available. Or they have 1-2 towels for the whole family to use and none of them are clean.

Anyway:
Cord clamp
Instruments
Pitocin and Syringe
Towel
Gloves
Chux Pad (I'm a little crazy about avoidable messes)

Here's what is in the ebay "emergency childbirth kits"
1 Baby Blanket: To cover the baby after birth. Helps prevent hypothermia.
1 Plastic Carrying Case: Can be used to recover the placenta while it is being delivered.
1 Sterile Ear/Ulcer Syringe: Used to clear the baby's nose and mouth of mucus.
2 Sterile Umbilical Cord Clamps: Used to clamp off the umbilical cord. Position the clamps about 4 to 6 and 8 to 10 inches from the baby's navel.
4 Disposable Towels: Used for general purpose cleaning and wiping.
1 Pair Sterile Latex Gloves: To be worn by the assisting person.
1 Infant Cap: Placed over the baby's head to prevent hypothermia.
1 Ziplock Biohazard Bag: Place soiled items in this bag. Take with you to hospital.
2 Sterile OB Pads, (Feminine Napkins): Self-explanatory.
6 Sterile Gauze Pads: For cleaning and wiping.
2 Wraps, 48"x 48": Place one under mom and cover her with the other.
1 Sterile Scalpel: For cutting the umbilical cord.

[Charmie981]

I've been to births where the baby's things were still in the package in the gift bags from the shower - no blankets available. Or they have 1-2 towels for the whole family to use and none of them are clean.

I have too, this is why my instructions say I need 6-8 towels laundered and place in a plastic bag, then set aside for the birth--out of kids reach so they won't grab a birth towel when they're looking in the linen closet. And I check it at the 36 week home visit . I'm picky about that...I guess we all have our things, right?

[mwherbs]

"100 F is HOT"
-- here in the summer the not in the car temps are 105-110 daily- in the car even higher-- like I said- fridge at home- freezer pack in car-- atleast for here-- I though that the package inserts changed around 2001 and it had to do with longer shelf life/pull dates --- thanks for the link Apricot--

[Robinna]

I don't know if this helps but my MW gave me the pit (actually it was ergot for my 1st birth) at my 37-ish wk appt to put in my own fridge so it would be there no matter what.
Robin

[mwherbs]

yep at the home visit we look at everything and I want towels and baby blankets set aside--- in houses with low resources I ask to have some things pre-packaged like we use to do - in paper or plastic bags--
also a chux will cover a baby and actually if skin to skin with mom will stay fairly warm-- in those pre-packs from medical supply places it is filled with plastic drapes and a thick paper "baby blanket"

[pamamidwife]

I'd have everything you listed BUT the deLee. I haven't used mine in years and if we need to use it, it's because of a blocked airway for resuscitation.

don't even get me started on bulb syringes! lol!