The epidural Re-dose checklist....

The Epidural Re-Dose Checklist – this checklist will assist you in epidural labor analgesia management.

•   Is the patient experiencing pain or discomfort?
  
•   Is her pain Verbal Rating Scale (VRS) ≥ 4 (out of 10)?
  
•   Did the patient obtain previous relief with the current epidural catheter?
  
•   Does the patient have a bilateral T-10 level?
  
•   When was the patient’s last vaginal exam? What is her cervical dilatation?
  
•   Does the patient have complete cervical dilatation? Is it time to push?
  
•   Does the patient have a full bladder? Does her bladder need emptied?
  
•   Does the patient have a 1-sided block? Is she turning every hour?
  
•   Is the PCEA infusion running/working adequately?
  
•   Is patient pushing her PCEA button appropriately?
  
•   Has dystocia/CPD/FTP been ruled out? Is she a candidate for CS?
  
•   Have you checked the catheter site? Is the catheter site intact? Has the catheter moved out of position from its original placement?
  
•   Has the patient had ≥ 2 re-boluses? If so, consider replacing the epidural cathete
  
  
  Thanks to Dr M. Vallejo for university of Pittsburg for this awesome paper