[RainDreamer]

Originally Posted by Elvish

GBS sepsis
Reflux, as others have said

This specific episode reminds me of a kid we had about 18mo ago - was doing great, about 30 hours old, had been nursing like a champ. He was late preterm - 36 weeks I think. In for his carseat test, desats/bradys and turns the color of my neighbor's wisteria. Transposition of the great vessels. Needless to say, won himself a ticket to some immediate cardiac surgery. Mom was a basket case, understandably.

Scary!

Cardiac is what first came to mind when I read the OP ...... a closing PDA on a PDA-dependent cardiac kid is dang scary.

[dawngloves]

Originally Posted by Elvish

This specific episode reminds me of a kid we had about 18mo ago - was doing great, about 30 hours old, had been nursing like a champ. He was late preterm - 36 weeks I think. In for his carseat test, desats/bradys and turns the color of my neighbor's wisteria. Transposition of the great vessels. Needless to say, won himself a ticket to some immediate cardiac surgery. Mom was a basket case, understandably.

That happened on our unit once. 36 weeker in for r/o sepsis, coded during a car seat test. Ended up going home on a monitor after a million dollar workup that yielded nothing.

[littleneoRN]

Originally Posted by Elvish

GBS sepsis
Reflux, as others have said

The OP said that the baby is six weeks old, so I think we can rule out GBS sepsis. Probably can rule out CHD too, although I once saw a term kiddo come in at 2 months of age because he apparently had had a PDA that finally closed (unbeknownst to anyone) and he had a pretty significant coarct that finally showed up as symptomatic.

[Elvish]

I posted that response before I read that babe was six weeks old.

[danissa]

Curious as to why you had a 38 weeker at 6 weeks old still in the hospital??

[Nicky30]

The babe had been discharged at 7 days of age but had two readmissions for failure to thrive.

This was the second readmission and babe was due to be discharged later that day.

I heard today that the babe was monitored overnight in the city, and discharged the next day on oral AB's. Nil further episodes (so therefore nothing is wrong??)

Parents have purchased and apnoea monitor. I pray everyday for that little family.

Nicky.

[SteveRN21]

Must be different in Oz.

We almost NEVER readmit a baby to NICU once they go home. I've only seen it once, and it was when the baby had been with us forever, and had gone home the day before.

All others go straight to peds or PICU once readmitted.

[RainDreamer]

We never re-admit to NICU either. The only time I saw it happen was when a kid of ours was transferred to PICU, went home from PICU, was re-admitted to PICU, and then transferred back to us because they needed the bed space.

[SteveRN21]

We DO admit babies that were born normally and sent home for 1-2+ weeks before someone found a murmur/TGA/etc.... doesn't make much sense, since, "technically" our Peds Cardiac ICU "could" handle it. We do have 10 beds for every one of theirs...

[corks]

Eventhough there was no recent feed this could still be reflux or aspiration as different babes have different transit times. The blood sugar is high which could be due to stress or infection especially as your blood cultures have shown a growth. Do you know what the white cell count was or c reactive protein? This would also confirm infection. Sometimes you don't get a full explaination as why these episodes happen but it sounds to me as if you handled the whole situation very professionally. You need to ask one of your senior grades or nurse practitioners for a debrief. Your experience would make a good reflective piece if you are maintaining a professional portfolio.