Development of NEC- questions for you!

Specialties NICU

Published

Hey, guys, I have some questions. Do any of you have any experience with babies who've developed NEC and/or perfed on your shift? I figured you do :), but would you mind sharing your experiences? What kinds of things did you start to see happen with the baby? Did the doctors know about it as it was happening? What sort of orders were made as this occurred, etc.? What are early signs of a baby developing NEC, as you've seen them? I have a lot to look up in my texts, but figured that some of you may have some firsthand experience that you'd be willing to share? I'd like to hear anything you have to say about it. Thanks! :>)

Kristi

Specializes in NICU, Infection Control.

Was a surgeon consulted? And when? The only thing I can suggest is that girths need to be checked q feed on any premie, esp one that's upchucking.

Remember my old signature line? Let me repeat:

NEVER, EVER TRUST A 35 WEEKER!

NEC can present in a catastrophic fashion, complete w/overwhelming sepsis. This baby gave you little, tiny hints, then just crashed.

Sometimes, you'll have a baby that just doesn't "feel right" to you. ALWAYS pay attention to that intuition. If the docs won't listen, document the details--girths, hemacults, ask a more experienced nurse to assess w/you. With all the details you remember, something was telling you the baby was not OK. I think you are developing that sixth sense--which is a MAJOR step toward expertise. You're not just dong a series of tasks, you're evaluating at some interior level [that you may not be aware of] the data you are collecting and documenting.

No matter how long you are doing this, the kids can always pull a fast one on you!! Just less of them as time goes on.

Specializes in NICU, Infection Control.

Was a surgeon consulted? And when? The only thing I can suggest is that girths need to be checked q feed on any premie, esp one that's upchucking.

Remember my old signature line? Let me repeat:

NEVER, EVER TRUST A 35 WEEKER!

NEC can present in a catastrophic fashion, complete w/overwhelming sepsis. This baby gave you little, tiny hints, then just crashed.

Sometimes, you'll have a baby that just doesn't "feel right" to you. ALWAYS pay attention to that intuition. If the docs won't listen, document the details--girths, hemacults, ask a more experienced nurse to assess w/you. With all the details you remember, something was telling you the baby was not OK. I think you are developing that sixth sense--which is a MAJOR step toward expertise. You're not just dong a series of tasks, you're evaluating at some interior level [that you may not be aware of] the data you are collecting and documenting.

No matter how long you are doing this, the kids can always pull a fast one on you!! Just less of them as time goes on.

Dobhoff!!!!Drop a Dobhoff!! Geezz! Iz m a nerze! LOL! BTW Kristi. I bookmarked that site.

Dobhoff!!!!Drop a Dobhoff!! Geezz! Iz m a nerze! LOL! BTW Kristi. I bookmarked that site.

Specializes in NICU, PICU, PACU.

That sounds like a nice case of NEC to me! Usually those kids start looking icky and then it is downhill from there.

We have had alot of full termers lately with NEC....perfed NEC.

And you can have a kid that has been feeding for a while, even up to full feeds and they can develop NEC...sometimes those are the kids with the insidious abd. problems...puking here and there, had feeds held a few times. After a while you'll be able to peg those kids and say "Yup that one is a big ole setup for NEC!"

Specializes in NICU, PICU, PACU.

That sounds like a nice case of NEC to me! Usually those kids start looking icky and then it is downhill from there.

We have had alot of full termers lately with NEC....perfed NEC.

And you can have a kid that has been feeding for a while, even up to full feeds and they can develop NEC...sometimes those are the kids with the insidious abd. problems...puking here and there, had feeds held a few times. After a while you'll be able to peg those kids and say "Yup that one is a big ole setup for NEC!"

When I just started working with the neonates,I was told that those formula fed babies are more prone to NEC & it was proven when I`ve seen babies developing NEC so slowly,puking for 24hours or so,visible veins on abdomen,not passing stool >24h etc. it was when I was in the countryside,but when I moved to a city,the scenario was so different most of the babies who had NEC actually were on breastmilk,and the effect of NEC was so quick,I just handed over to the night staff that the baby was fine,stable vital signs apart from resps of 80-100br/min,tolerating feeds,opening bowels to a soft yellow stool every diaper change(4-6h).Then the following day(

When I just started working with the neonates,I was told that those formula fed babies are more prone to NEC & it was proven when I`ve seen babies developing NEC so slowly,puking for 24hours or so,visible veins on abdomen,not passing stool >24h etc. it was when I was in the countryside,but when I moved to a city,the scenario was so different most of the babies who had NEC actually were on breastmilk,and the effect of NEC was so quick,I just handed over to the night staff that the baby was fine,stable vital signs apart from resps of 80-100br/min,tolerating feeds,opening bowels to a soft yellow stool every diaper change(4-6h).Then the following day(

Specializes in NICU, PICU,IVT,PedM/S.

About 3 years ago I was just coming on shift @ 3:00pm reading my chart sitting at the bedside. I had a maybe 1 week old 25ish weeker in an isolette. She had a desat down into the 30's followed by a brady that required several minutes of bagging to bring her back. By 6:00 pm we were in the OR with an ostomy. She had still been NPO, not reported to be distended, ropey.....

Long story short @ 430am I was still catching up the pages of orders.

Specializes in NICU, PICU,IVT,PedM/S.

About 3 years ago I was just coming on shift @ 3:00pm reading my chart sitting at the bedside. I had a maybe 1 week old 25ish weeker in an isolette. She had a desat down into the 30's followed by a brady that required several minutes of bagging to bring her back. By 6:00 pm we were in the OR with an ostomy. She had still been NPO, not reported to be distended, ropey.....

Long story short @ 430am I was still catching up the pages of orders.

Specializes in NICU.

Wow, well I guess THAT answers my questions. Thanks, all of you, for your replies. I'm learning so much! It's exciting! I know, I'm a nerd! :D I can't help it.

Specializes in NICU.

Wow, well I guess THAT answers my questions. Thanks, all of you, for your replies. I'm learning so much! It's exciting! I know, I'm a nerd! :D I can't help it.

+ Add a Comment