[phiposurde]

I finally got my first mission. It was a month old baby with possible obstruction. At the sending hospital before transport I try to insert an NG but there was resistance and I sure didn't want to do any damage. Any trick of the trade? Do we have to do anything different vs adult?

[NREMT-P/RN]

Congrats! on the first mission.

Are you rotor or fixed and what kind of transport times do you guys have? Flying a month old (hopefully, term) with a (presumed) intestinal (?) obstruction can make air transport an interesting transport choice. Any airway considerations? The little ones can be pretty sick, so...

If I had a controlled airway (or needed to) I'd place an OG - but, the transport fairies rarely bless us (and these blessed patients) with easy choices.

No real secret for NG placement in wee ones - lots of risks in these populations though.

Lots of help, small flexible NG tube, analgesia/lubricant and a confirmation x-ray when placed as a standard for NG (you can check pH - but, why are we transporting and other considerations may demand the confirmation x-ray).

Good Luck.
Fly SAFE!

[phiposurde]

[quote=NREMT-P/RN;2529836]Congrats! on the first mission.

Are you rotor or fixed and what kind of transport times do you guys have? Flying a month old (hopefully, term) with a (presumed) intestinal (?) obstruction can make air transport an interesting transport choice. Any airway considerations? The little ones can be pretty sick, so...
****I'm rotor. I am base up North of Alberta. We do get strange call cause something we are the only ALS crew availabl;e or ground is way to long. We did a transport last month I think of 7.5 hours!!! These big debate right now in the area that we deserve about who should transport who. W e use to have an peditric transport team in the south but the are no longer.

If I had a controlled airway (or needed to) I'd place an OG - but, the transport fairies rarely bless us (and these blessed patients) with easy choices.

No real secret for NG placement in wee ones - lots of risks in these populations though.
** that's what I thought!!

Lots of help, small flexible NG tube, analgesia/lubricant and a confirmation x-ray when placed as a standard for NG (you can check pH - but, why are we transporting and other considerations may demand the confirmation x-ray).
**** thanks for all the info!!!

[FlyingScot]

Right side is usually easier than left due to anatomy. OG route as an alternative is usually tolerated well by small babies. Sump tubes are too stiff if you even have one small enough. Andersen tubes rock in babies with GI issues.

[prmenrs]

You can put a repogle in orally. About a 12F is all you should try. Use some hot water on it to soften it, then curl it around your finger till it's a little cooler. It should slide right down.

An NG tube that is big enough to actually drain stuff is probably too big for their nose. You may be able to get it in there, but it will cause damage. That's why an OG is better.

(I'm not a transport nurse, just a NICU nurse.)