Quote from philosophical
What problems do NICU patients usually have besides low birth weight/ early gestational age? How many patients on average die each month?
Off the top of my head; I'm sure many more nurses can add to this: Congenital heart disease, malformations of the gut, bones, lungs, brain, kidneys, congenital infections, meconium aspiration, congenital diaphramatic hernia, tumors/masses, metabolic disorders, ABO/Rh incompatibility, hypoglycemia, hyperbilirubinemia, genetic disorders (trisomies, etc), feeding problems, skin pathologies, and many more.
Deaths seem to come in waves. On our 65 bed level IV, I'd say average 2-3/month? Sometimes we lose a bunch in a week, sometimes we go awhile without one.
And as per the original question: we can be anywhere from 1:1-3 on the unit with as many as four in our step-down. Last night was particularly bad: I had my primary, who is a six month old ex-CDHer, s/p ECMO, nissen, GT, developed respiratory failure a month ago and is still intubated on high settings with Nitric and frequent neb treatments, feeding q3, has terrible bronchospasm when agitated, requiring sedation and sometimes bagging. Then I had a four month old ex-32wk kid with multiple anomalies, including TEF that they've somehow been unable to fix, has a chest tube and J-G tube, just started feeding right before my shift, so had to monitor for problems with that, with neuro issues that make him scream inconsolably for periods of time, and if you give him anything stronger than acetaminophen he loses his respiratory drive and tries to die. Oh, and he coded the day before when he was in the OR for JT revision, been fine since, but you never know. Then I had a feeder with no major issues, but it still takes time to feed/change a kid, and with that first one, you have to respond to his little episodes pretty much immediately, so the time it takes to even put her back in the isolette and get to the next room is really scary. Oh, and she was also a rocket pooper, so there was a lot of cleaning going on.
Sorry to hijack the thread! :trout: I need chocolate.