[daniela]

Sorry for my outburst but I need it! Now I can submite you some doubt; if for you these problems can be common, I'm sorry but I'm a nicu nurse only since two years! I'd like to know when you must suction the nose of a preemie with NCpap (we use infant flow sistem) you simply remove the nasal o2 support and make it or do you make something to mantain o2 level during procedure?
How many times for week do you make a bath to the baby, and also when do you use sterilized water (if you use it)?
For the moment I thin that's enough; thank's in advance ang good summer to all (today I was in the beach and it's really a good day! )

[dawngloves]

Lucky you at the beach!
When I suction a baby on CPAP or nasal cannula I hold it just below the nose so they at least get a little flow. It doesn't take that long.
A feeder/grower I'll at least wipe down with soap and water QD, might put in a tub once a week. We use tap water.
If I am wiping down a very young preemie's face I will only use sterile H2o.

[daniela]

Have you experience with skin of 22|23 weeks? When they have some skin's infection they are similar to burned patients. I think so and everyday I think also it's necessary to clean the skin; luckily I've had only two experience and in this case I'have used to wash only sterilized water.Prob ably it's necessary also to use steril drapre around the baby.Thank's

[dawngloves]

I can't say I've ever really bathed anything less than 25 weeks. Maybe a quick wipe with sterile water so the parents don't get upset from the blood.
Never seen any with a skin infection either.

[prmenrs]

I think with a baby less than 27 weeks, for the first week, they are placed in high humidity (provided by the same kind of heater used for the ventilator and sterile water) and they also get their skin coated with Aquaphor--I'm sorry, I don't know the generic name. All lines are sewn in, and the heart rate is counted from the UAC monitor, so they don't need lines.

After about a week or so, the skin has developed a little more, and they don't need the moisture or the Aquaphor, but you can still put it on their bottoms.

I would not bathe them unless absolutely necessary, but you could heat a small bottle of sterile water, and wipe them down if you wanted. After about 2 weeks, put a couple of drops of baby bath or shampoo into the sterile water. Do not use regular soap on the baby's skin, it is drying and the pH is too alkaline--it destroys the "acid mantle" of the skin that helps protect from bacteria.

[daniela]

Thank's a lot, we have to change many things. Can you help us whit some internet addresse/books name where we can find lineguide about this? Daniela

[prmenrs]

http://www.awhonn.org/awhonn/?pg=874-2190-6030 This reference is from AWOHNN, it may help you, not sure.

Carolyn Lund RN, MSN, FAAN, Children's Hospital of Oakland, Oakland, CA is a noted expert on skin care of extremely premature infants. Anything you can find from her would be well referenced and respected.

[daniela]

Thank you very much! You are really a precious source...........; have you also something about iv medication? The italian preemies say thank's to all!Daniela

[natasha700]

Originally Posted by daniela

Sorry for my outburst but I need it! Now I can submite you some doubt; if for you these problems can be common, I'm sorry but I'm a nicu nurse only since two years! I'd like to know when you must suction the nose of a preemie with NCpap (we use infant flow sistem) you simply remove the nasal o2 support and make it or do you make something to mantain o2 level during procedure?
How many times for week do you make a bath to the baby, and also when do you use sterilized water (if you use it)?
For the moment I thin that's enough; thank's in advance ang good summer to all (today I was in the beach and it's really a good day! )

It really depends on what facility you work in. Some have sets days like even and odd or every day. Of course if their temp is not stable you don't give a bath. I personally don't like to bathe preeemies that are 2-3lbs I use water sparingly and usually bathe them in the isolette. Whatever works and promotes optiminal care and doesn't cause harm. We don't use sterilized water although I did work in anal unit where you had to put your soiled diaper in a zip lock for fear of pseudomonas! Yeah, right! As far as suctioning their noses if they are not maintaining their sats despite the cpap I don't see it as a problem unless it is contraindicated. You will find as you learn in this unit you will have to make judgements for the best outcome of your baby. For instance, a kid with PPHN you wouldn't dare do a thing to them because we all know they will dump on you and the neonate doctor will tear you a new one.