On-call scenario 1: Introduction

Last updated: Friday, July 08, 2016

Scenario 1
"Hello. It’s one of the midwives on the antenatal unit. I have a patient with a magnesium infusion running but she needs a dose of cefuroxime and metronidazole too. Can they all go down the same line?"
Of course you'll need more information than this, which you'll get by asking questions about the caller, the patient, her medicines, and the clinical situation. This is what you discover...

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Caller: Sue Harding, midwife, antenatal ward, ext 6077.

Patient: Michelle Cox, hospital no. 1414777.

Medicines:
Magnesium sulphate 20% intravenous infusion running at 1 gram (5ml) per hour. Total volume of infusion 50ml diluted in sodium chloride 0.9%, as per your Trust's protocol. No known drug allergies.

Clinical problem: Patient has eclampsia and is having an emergency caesarean section this evening. She has been prescribed intravenous cefuroxime 1.5 grams and metronidazole 500mg to be given at anaesthetic induction. A midwife has already added the dose of cefuroxime to the 100ml metronidazole infusion bag. Patient is difficult to cannulate but has a single lumen peripheral line.


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