Magnesium Sulfate

[rhan101277]

I wanted to see if anyone has had any experience in administering this drug to stop contractions. What conditions did you use it for?

I know it can be used for mothers with gestational diabetes that have big babies that need a C-section.

Do you want to stop contractions so as not have the baby in the back of the ambulance? If its coming, its coming though right?

 

[Onceamedic]

Mag is in our protocols for eclampsic seizures, torsades and status asthmaticus refractory to epi only. It is not used to control contractions. I can't imagine anywhere in pre-hospital protocols that that would be an accepted use.

 

[Lifeguards For Life]

Mag is in our protocols for eclampsic seizures, torsades and status asthmaticus refractory to epi only. It is not used to control contractions. I can't imagine anywhere in pre-hospital protocols that that would be an accepted use.

I think pre hospital tocolysis generally only allows for hydration and sedation

there are also studies showing other drugs such as Terbutaline, nifedipine to be safer, and equally or more effective.

 

[MSDeltaFlt]

I wanted to see if anyone has had any experience in administering this drug to stop contractions. What conditions did you use it for?

I know it can be used for mothers with gestational diabetes that have big babies that need a C-section.

Do you want to stop contractions so as not have the baby in the back of the ambulance? If its coming, its coming though right?

It depends. If the child is of late enough gestation to be viable and you have an eminent birth with no signs of abnormal presentation, why would you want to stop contractions?

If you have any of the above then you'd might want to start a Mag drip as a bolus so long as you're that far away in the county. If you're in town, then you won't have enough time to get the drip going good before you'd be backing up at the ER.

Bare in mind that even starting a Mag drip requires a thorough pt assessment first because you have to remember that child birth is normal. It's what happens when you have unprotected sex. Human beings have been doing this without EMS for millions of years with no problems. Your parents did it. My parents did it, although my older brothers kept telling me I was hatched.

Basically what I'm saying is I wouldn't be so quick to start a Mag drip just to stop contractions. Mainly because the effects of Mag last a while after the drip is over. So be careful.

 

[rhan101277]

I am just asking because this was on a test and I missed it. I thought mag sulfate was just used after valium to stop seizures related to eclampsia.

Here is the test question:

You are called to transport a 28 y/o 32 week gestation female to a tertiary care facility. The patient has been in labor for the last three hours. The transferring physician states that the patient is fully effaced and dialed to 4 cm. Enroute to the hospital, the patient's contractions increase in frequency and duration. You contact med control and ask for which orders to administer which of the following medications to stop the contractions?

I selected Pitocin 20 units IV; I know its a stupid answer because it induces labor, but I definitely didn't think about mag sulfate for this. It is a smooth muscle relaxer though and works on acetylcholine and the motor end plate.

 

[Lifeguards For Life]

I selected Pitocin 20 units IV; I know its a stupid answer because it induces labor, but I definitely didn't think about mag sulfate for this. It is a smooth muscle relaxer though and works on acetylcholine and the motor end plate.

i thought magnesium lowers calcium levels in uterine muscle cells. Since calcium is necessary for muscle cells to contract, mag sulfate causes relaxation of the uterine muscle?

mag sulfate does not stop contractions, just slows them down right?

 

[rhan101277]

i thought magnesium lowers calcium levels in uterine muscle cells. Since calcium is necessary for muscle cells to contract, mag sulfate causes relaxation of the uterine muscle?

mag sulfate does not stop contractions, just slows them down right?

That is right, but calcium being blocked caused reduced acetylcholine release. Which should slow them, the test said stop though so :wacko:

 

[rescue99]

Mag is in our protocols for eclampsic seizures, torsades and status asthmaticus refractory to epi only. It is not used to control contractions. I can't imagine anywhere in pre-hospital protocols that that would be an accepted use.

Mag may not be used in the pre hospital setting but it sure is used in house!

I remember 4 things about having a Mag drip. It warms a body up nicely. It caused the worst headache of my life. Renal compromise was a concern and they kept me in LD for the duration of its use.

 

[gamma6]

it's in ours as well..1-2 grams, same as torsades de pointes