"cpap Head"

  1. Ok, need some info on everyone's CPAP experiences. Most of our babies have the kind with 2 corrugated hard plastic tubes held on their head with 2 blue sponges and a cap that has a band to secure around it. Sorry, don't know the brand name. Anyway, the babies end up with these horrible dents in the side of their heads from where the band goes around the sponges. Their heads end up really long like their brains get squashed to the back. Apparently I am the only person who finds it inappropriate that we are disfiguring the critters....regardless of how well they eventually mold back into shape post-cpap. WHAT IS GOING ON????????? We have finally started paying attention to septums and nares and have decreased the horrible plastic surgery candidates.....yippee for us.....It's like everyone is just ignoring this issue which in my opinion is totally a nursing responsibility. Am I alone here??????? Is everyone else in the country creating our future kindergarten classes of aliens???
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  2. 9 Comments

  3. by   dawngloves
    Our kids are on prong CPAP, not bubble and I assume that's what you have. We trialed it and had a hook up where we pinned it to a hat. YKWIM? I'm not sure if that'll help, but maybe a start?
  4. by   NICU_Nurse
    ROFL!

    A kindergarten class of aliens? I got the most hilarious visual of that just now:

    28 tiny kids (growth retardation r/t premature birth) with huge, pig-like nostrils and tall, skinny heads staring down the teacher as she enters the classroom!

    LOL Thanks. ;>)

    Seriously, I don't see this as much of a problem on our unit. We use doughnuts made by OT/PT to help round their heads out and return them to semi-normal once they're off CPAP. Our kids don't stay on CPAP very long, though, so maybe this could be a reason I don't see that problem much. All our kids end up with toaster head, but I am a vigilant user of the doughnuts (if you've never seen them, think of a hemmorrhoid (sp?) doughnut only small enough to fit just outside of the baby's head with their skull resting in the middle) with any baby who's with us for more than a few weeks. It helps a LOT. The nostrils are another story...
    Last edit by NICU_Nurse on May 16, '03
  5. by   KRVRN
    It's not getting elongated from the hat being too tight is it? I've seen that before if a baby is on CPAP for awhile. The baby can grow out of the hat and the head gets elongated.
  6. by   NICU-RNHeather
    we have the hardest time keeping their little mouths closed with the bubble cpap...secret...we use a bili light eye patches ever so lightly around the chin and it seems to help with the connection, as far as the prongs go, i see a bit of irritation in and around the nose, any suggestions? sometimes very frustating....
  7. by   jeffinerrn
    Kristi,
    ROFL! I love that visual!!!
    Hi, I'm new here. I was surfing today and found this site. It's nice to have a place to connect directly with others and hash out our concerns! and to share ideas.
    Heather, that's a great idea with the bili mask! I'll have to suggest that in our NICU. the only thing we do for the irritation is treatment rather than prevention. we are using polysporin with lidocaine to help for extended periods on cpap.

    thanks for a wonderful forum for discussion
    Jenn
  8. by   dawngloves
    We do the mask thing with CPAP. But I worry that these kids will have killer TMJ as adults!
  9. by   NicuGal
    I hate CPAP head! I don't think there is a thing we can do about it...we use the same setup as you and they end up with this tall head and squashed in sides...not attractive at all.

    We duoderm the septum and under the nose to help with the breakdown...also helps to keep it in place a bit better.

    We aren't allowed to tie the mouth up...we had one kid aspirate because of that (yes, we feed on NIMV or CPAP), so now we just have to adjust the vent to compensate for the airleaking.

    We also don't use anything in the nose because most of the ointments aren't water soluble. We do use ParaLube (I think that is the name), it is really artifical tears in an ointment form. Works great to keep the boogies loose and the inside of the nose moist! We use it on the high flow cannula kids too.

    Aren't you guys concerned with the lidocaine in the ointment?
  10. by   jeffinerrn
    We use 1% lidocaine and only use is QID. and that's only when there's breakdown. I like to eye ointment idea though, the boogies is one of the biggest problems, (in addition to the Kindergarten Alien thing):chuckle
  11. by   Deb Bobola
    Hi, I enjoyed a good laugh with this visual! I have a stupid question....how tight are you wrapping the velcro strips around the tubing? That can cause the dreaded head. We also use duoderm at the septum. This can add more area of breakdown though if the prongs are shoved in too high.

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