Nancy is nine months pregnant and is quickly taken to the hospital after her water breaks. Upon arrival at the hospital she is triaged and placed in a room. The doctor comes in and asks Nancy what kind of pain management she wants during the delivery. Nancy has researched the different options before coming to the hospital but was still unsure about what to choose. She knew an epidural was the most common option but like with all medication side effects are very common which made her nervous they would affect the delivery and/or her child. She had also read about a newer option that was nitrous oxide (N2O) but was still torn on what to prefer.
This is an illustration of a problem that most pregnant women encounter before the birth of their …show more content…
However, I feel that the evidence they provided supports the nature of my specific intervention in terms of areas relating to promotion of N2O use over epidurals as a primary pain intervention. The chosen intervention was largely focused on side effects and benefits/disadvantages of epidurals versus nitrous oxide. While certain side effects such as headache, pain, and nausea are subjective in nature, others such as maternal hypotension, fever, and being confined to bed, can be considered in objective terms. The general strengths of the evidence are sample size, in that most were large and appropriate to the study, as well, data presented has significant clinical implications. The weaknesses of the articles relate to author/selection bias, lack of randomization, and the fact that most studies were not …show more content…
The expected outcome of this intervention is adequate pain management for women in labor with fewer and less serious adverse effects for both the mother and child. I am promoting the use of N2O as a first line analgesic choice for women with uncomplicated births in labor lasting less than 24 hours. There is evidence that suggests N2O should be avoided in patients undergoing major surgeries, such as a cesarean section, not only because it is a weaker anesthetic, but because it also decreases the amount of oxygen that is inspired. This has shown to increase post-operative complications such as infection in patients given nitrous oxide for surgeries (Myles, Leslie, Chan, Forbes, Paech, Peyton, Silbert, Pascoe, 2007).
A key component in the implementation of N2O use is education, both for the patients as well as practitioners. In order to educate women about the viability and benefits of N2O during labor, the plan is to provide handouts during tours of labor and delivery units with a question and answer session upon conclusion of the tour. Education about N2O will be primarily directed toward women who want to avoid the use of an epidural or who want to wait before using an
This is an illustration of a problem that most pregnant women encounter before the birth of their …show more content…
However, I feel that the evidence they provided supports the nature of my specific intervention in terms of areas relating to promotion of N2O use over epidurals as a primary pain intervention. The chosen intervention was largely focused on side effects and benefits/disadvantages of epidurals versus nitrous oxide. While certain side effects such as headache, pain, and nausea are subjective in nature, others such as maternal hypotension, fever, and being confined to bed, can be considered in objective terms. The general strengths of the evidence are sample size, in that most were large and appropriate to the study, as well, data presented has significant clinical implications. The weaknesses of the articles relate to author/selection bias, lack of randomization, and the fact that most studies were not …show more content…
The expected outcome of this intervention is adequate pain management for women in labor with fewer and less serious adverse effects for both the mother and child. I am promoting the use of N2O as a first line analgesic choice for women with uncomplicated births in labor lasting less than 24 hours. There is evidence that suggests N2O should be avoided in patients undergoing major surgeries, such as a cesarean section, not only because it is a weaker anesthetic, but because it also decreases the amount of oxygen that is inspired. This has shown to increase post-operative complications such as infection in patients given nitrous oxide for surgeries (Myles, Leslie, Chan, Forbes, Paech, Peyton, Silbert, Pascoe, 2007).
A key component in the implementation of N2O use is education, both for the patients as well as practitioners. In order to educate women about the viability and benefits of N2O during labor, the plan is to provide handouts during tours of labor and delivery units with a question and answer session upon conclusion of the tour. Education about N2O will be primarily directed toward women who want to avoid the use of an epidural or who want to wait before using an