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Nursing Responsibilities in Preventing, Preparing for, and Managing Epidural Emergencies

Mahlmeister, Laura PhD, RN

The Journal of Perinatal & Neonatal Nursing: January-March 2003 - Volume 17 - Issue 1 - p 19–32
Continuing Education

An increasing number of women receive epidurals during labor and birth. Although the incidence of adverse reactions remains very low, the potential for life-threatening complications still exists. The Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) states that the safety of women undergoing procedures, such as the administration of epidural analgesia/anesthesia, depends significantly on the competence, attentiveness, and experience of those responsible for their care. The purpose of this article is to review the significant complications related to obstetric epidural. Recommendations are presented to aid the nurse in preparing for and managing epidural emergencies. Specific responsibilities of nurse managers and educators in competency training, evaluation, and guidance of nurses are also discussed.

From The Birth Center at San Francisco General Hospital, San Francisco, Calif, and Mahlmeister and Associates, Belmont, Calif.

Corresponding author: Laura Mahlmeister, PhD, RN, 1567 Winding Way, Belmont, CA 94002 (e-mail:

Submitted for publication: September 6, 2002

Accepted for publication: October 24, 2002

© 2003 Lippincott Williams & Wilkins, Inc.