AllyIII 576 Views
Joined: Jun 16, '05;
Posts: 4 (0% Liked)
We do 4 BP's but we get lots of PPHN's, and potential ECMO's so it's just easier to do it on everyone
Certainly there's nothing wrong with doing BP x 4 ext. and kaibigan, you need to follow your hospital's protocol. But as prmenrs said, as a standard admission protocol I agree that there is poor return on time invested. If there is indication of desaturation, PPHN, murmur or irregular rhythm, then those circumstances would indicate a need for further BP monitoring. The results of 4 point BP with varying pulse pressure are not always indicative of a problem and conversely, the difficulty in obtaining consistent measurements on all 4 ext.will not always give accurate data. (in other words the BP data may indicate a problem exists when it really doesn't OR there may be a problem that won't be reflected in the BPs because in the difficulty in obtaining them.)
If the pulse pressures vary on these BPs but there is no other indication of a cardiac issue, what do you do with this info? In my experience, you tell the doc and they say "yeah, ok, well just watch him" which is what you are going to be doing anyway.
I work in a Level III and all of our babies even 24 wk are seen for OT/PT consults. Especially just for positioning, and all of our RN's take a developmental care class. Also I work at a Children's Hospital that doesn't do deliveries, so we have a lot of babies that need surgery and ECMO. I can send the developmental stuff if needed.
I need to know what other NICU are doing in their unit for an early referral to OT/PT consult. What are the criteria..such as how early do you refer kids..at birth or at certain gest. age...etc. ANd if your unit are doing it what are the outcome. We are having problem in our unit.It seems like we either missed a kid or it's too late to refer them...unless they are taken by our NNP service.WE have alot of kids that have alot of motor,feeding and developmental issues because of this, and our Medical director don't want an automatic referral to OT/PT unless it is needed or desperate. So, I need info pls. Thanks :hatparty:
We change ours once a month, our infection problems are more central line in nature. We check residuals before every feed unless otherwise indicated. Also pH testing every one.
when you use corpaks, how often do you change it? also, how often do you check for 'residual' or 'gastric aspirates'?
according to one of my colleagues, it is not necessary to check for the corpak placement prior to giving the bolus, intermittent or continuous feeds. on the other hand, there is also another colleague of mine who said that i am supposed to check it everytime before i start with any type of feedings. your opinion matters a lot to me. thanks!
how often do you change the dressing for central lines, broviac?
do you have a special nurse to change it?
does anyone has a policy on this?
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