are you going to sneak food at the hospital? - Page 2 - Mothering Forums
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#31 of 36 Old 09-24-2006, 11:47 PM
 
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Originally Posted by wifeandmom View Post
Had to wait for DH to get home for this one.

He says cuffed tubes are for adults, uncuffed are for peds.

Having the cuffed tube inflated DOES protect the airway from aspiration, BUT you put the patient under THEN insert the tube, leaving the opportunity for aspiration after patient is under but before tube is inserted and inflated.

There is also the risk of aspiration AFTER the tube is removed but before the patient is fully alert again.

Does that make sense?

Edited to add he said IF the tube is inflated exactly as it should be with no space whatsoever, the patient won't aspirate with it in place, but you are still left with the time before the tube is in place and after it is removed but before patient is alert that the concern for aspiration is highest, thus the no food or drink rule. Also, even the tiniest bit of error can allow liquid contents to enter the lungs, so it's just a whole lot simpler if patient has an empty stomach.
Except that pregnant women, by definition, never have empty stomachs (progesterone causes delayed emptying), and gastric secretions (with their pH of 1) have been shown to cause aspiration pneumonia.

Must have lucked out, because I know I've been intubated with an uncuffed ET as an adult, and damn, that was more comfortable the next day. Or my anesthesiologist was confused as to my age .

mama to Max (2/02) and Sophie (10/06); wife to my fabulous girl
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#32 of 36 Old 09-25-2006, 01:52 AM
 
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Originally Posted by maxmama View Post
Except that pregnant women, by definition, never have empty stomachs (progesterone causes delayed emptying), and gastric secretions (with their pH of 1) have been shown to cause aspiration pneumonia.

Must have lucked out, because I know I've been intubated with an uncuffed ET as an adult, and damn, that was more comfortable the next day. Or my anesthesiologist was confused as to my age .

You're right that pg women are treated as if they have a 'full stomach' regardless, but actually HAVING a stomach with food in it DOES make a difference in the risk of aspiration.

I'm not sure that DH meant uncuffed=peds and cuffed=adults as a matter of rule or if it is just his preference. Actually, he just said 'You don't use cuffed tubes with peds', so I'm thinking maybe it's up to the provider in question as to whether or not they use cuffed or uncuffed with adult patients.

Although...if cuffed tubes are available, it would make sense to use them on a pg woman due to the increased risk of aspiration even without food in the stomach. Hmmm....it would be interesting to hear opinions of various providers that choose not to use cuffed tubes in pg women for whatever reason.

DH is already asleep or I'd ask him why someone would choose to do it that way as I really have no clue whatsoever.
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#33 of 36 Old 09-25-2006, 04:39 PM
 
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This is what I brought (did not have to sneak):
Frozen banana, sliced
Yogurt
Vitamin water

When I threw up at 10 cm, it was only water, so everything digested easily.

BTW, the reason they don't want you to eat is in case you have a c/s under general anesthesia and they do not intubate your properly and you vomit and aspirate vomit while unconscious, which is about 1 in 1,000,000, literally.
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#34 of 36 Old 09-26-2006, 10:54 AM
 
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I packed snacks for my hospital birth last time. I wasn't all that hungry for the snacks and I only at a little of the sandwich, but I also ate all the jello and popsicles they had! I had a homebirth this time and I planned labor snacks and managed to eat them all as I went 16 days past my due date. I wasn't hungry anyway b/c I woke to contractions at four am and by 8 am she was here! I seriously inhaled a big bowl of oatmeal afterwards, though!
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#35 of 36 Old 09-28-2006, 02:40 AM
 
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I planned to sneak food. My doula brought honey packets and squeeze peanut butter, but I was ready to push when I arrived at the hospital - NO time to eat!
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#36 of 36 Old 09-30-2006, 04:40 AM
 
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For me, what I ate at the hospital remains one of the more amusing aspects of my hospital experience. I had intended to come prepared with healthy/light snacks and drink and my midwives had said I could eat and drink as much as I liked. In fact, they pushed the juice and water so much I thought I'd float away. As it was I was sweating so much during transition and pushing...anway - I digress. I think I did have a bag packed with food but dh got really hungry and since my labor was stalling he went out and got veggie sub sandwiches and veggie sushi. OMG that sushi tasted so good to me! And there I was with huge mouthfull of sushi when the midwife came in, came to a shocked stop, giggled, and said "Oh my - don't you dare let any of the nurses see you with *that*!" I was sort of surprised since that had always said food was OK. I guess veggie sushi was just not the typical thing. And - as it was - I never saw a nurse until pushing time and then she was in the background. I think my hospital birth was atypical for this country as I had midwives the whole time. Worked for me. I never threw up and I think the eating really helped as I was exhausted from a week of heavy prodromal labor. I needed the energy.

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