Term Bub with extensive cerebral bleed

  1. 3 days ago we had a baby girl transfer in form a country hospital who had begun seizing at 5min post birth..

    This was an uncomplicated delivery and a normal gestation.

    We did a US and found a large bleed and they decided to withdraw treatment, took the bub off the vent...she is still breathing, but is unresponsive and unable to tolerate her own saliva....the Docs decided to prescribe morp and Midaz so she can slip away peacefullly...
    this has been going on all day I feel terrible. as the baby keeps on going like she is ment to be here,and the parents are grief stricken just sitting by her side waiting.

    If she is still there tomorrow they are talking about letting her go home to die !

    I have never seen this before ....in my 5years in the NICU alot of the nurses feel upset about it although we know that her brain damage is severe.

    What do you guys think ?
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  2. 19 Comments

  3. by   DIPLOMATICRN4HIRE
    I think it is something that would be very hard to watch. Im sorry that it has occured but it sounds like the most humane thing to do for the child at this time. Compassionate care is the only thing left to do. The parents even grief stricken are allowed to hold their baby and love their baby and give it the best of all before its passing. Love and compassion. Be strong and help the family in anyway possible and grieve yourself. My prayers are with you and the family. I wish there was something helpful I could say.
    Zoe
  4. by   ShandyLynnRN
    my goodness what a terrible thing to have to go through! My heart goes out to you and all the nurses, and especially that poor family! I agree that considering the extensive brain damage, it is probably for the best, although still hard to deal with.
  5. by   aus nurse
    RN from OZ hugs to you. I am not experienced in NICU and can not offer expert advice by any means. I can understand this would be very difficult for you all.
    I don't know what is usual in a situation like this, but I see no reason why they could not go home, with support. The other option to consider is to transfer mum and bub back to their local country hospital where they can be much closer to family and friends and the support they will need.
    (((((RN from OZ)))))))))
  6. by   RNFROG3
    Oh Rn from Oz, my prayers are with all of you and the family.Do you have hospice nurses? They might be able to help the family transition and ours even help our nurses sometimes. God Bless.
  7. by   NicuGal
    That is so sad. I have seen a lot of kids like that, unfortunately, in my 16 years in NICU. Most likely, that baby will be long term comprehensive care. Unless her brainstem is involved, she is going to go on for quite sometime and most likely die of aspiraton pneumonia or sepsis. I don't know how it is in your end of the woods, but we have had kids like that and we don't send them home right away. We try to get hospice involved ( but they have to have a life expectancy of I think 6-12 months) and most likely we would start feeds on the baby and eventually she would have a GT placed. In the states, you have to provide nutrition one way or another. Then she would be sent either home or to the comp care floor, esp. if she can't tol. her own secretions. Sending a baby like that back to the hospital she came from would not be an option for us as this child needs specialized care.

    That poor family
  8. by   renerian
    How horrible to watch. My prayers to you the staff and the family...........

    renerian
  9. by   CashewLPN
    Nicu-- I was thinking the same thing as you.... That poor baby+family is gonna be around for a while... honestly, (please dont take this the wrong way...) its hard to kill a kid.... they do tend to keep on ticking....

    I've worked Inpt rehab and LTC... I've seen where people have been nearly vegitative for many years... and, just have kept ticking... GT, Trach, t&p q2h for life... its sad... (I had a teen with a massive ICH really young (like about 5 or so) who just kept going.... eventually died of sepsis at 18... it was very sad. his mom would come and read a story to him every night... )

    ok... well...
    best be to all involved...
    --Barbara
  10. by   aus nurse
    Originally posted by NicuGal
    Sending a baby like that back to the hospital she came from would not be an option for us as this child needs specialized care.
    Ah as I said it certainly isn't my area of expertise. I was thinking it was along the lines of purely palliative care, in light of the withdrawal of treatment. Thanks for explaining NicuGal.
    So tragic...thoughts for the little soul, her family and all you who are looking after her
  11. by   dawngloves
    I find caring for the term babies the hardest. You expect a perfest, healthy baby and then BAM! Someone like this. ((HUGS))
  12. by   ktwlpn
    Originally posted by NicuGal
    That is so sad. I have seen a lot of kids like that, unfortunately, in my 16 years in NICU. Most likely, that baby will be long term comprehensive care. Unless her brainstem is involved, she is going to go on for quite sometime and most likely die of aspiraton pneumonia or sepsis. I don't know how it is in your end of the woods, but we have had kids like that and we don't send them home right away. We try to get hospice involved ( but they have to have a life expectancy of I think 6-12 months) and most likely we would start feeds on the baby and eventually she would have a GT placed. In the states, you have to provide nutrition one way or another. Then she would be sent either home or to the comp care floor, esp. if she can't tol. her own secretions. Sending a baby like that back to the hospital she came from would not be an option for us as this child needs specialized care.

    That poor family
    "in the states you have to provide nutrition one way or another" ....Is that the law? Do you mean that if this were my child I would not have the option of taking her home and holding and rocking her in her nursery until she died? I would have to allow artificial feeding of some type causing her to go through 6 to 12 months of existence?
  13. by   RN from OZ
    It is not compulsory to feed in Australia. If you with draw treatment ...that is no NG or PEG feeds as well.
  14. by   Tweety
    I'm sorry you have to watch this.

    I would be as supportive as I can to the family. It's so brave to withdraw in cases like this. And in my opinion very kind to the child. They could be heroic, put a trach and a peg and have a little child live in a permanent vegetative state, a life of misery for who knows how long.

    But it must be just horrible to be a part of and watch.

    Take care.

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