Developmental Positioning, Aids, and stuff like that... - page 2

Hey, where do you guys get all of your developmental positioning stuff? I don't mean blanket rolls, I'm looking for specifically developed items used in positioning, bundling, etc. I found one site,... Read More

  1. by   UTVOL3
    Quote from prmenrs

    We make our own swaddling cloths--22"square calico, hemmed. Some babies get too hot if you swaddle them in hospital blankets. You can position them prone and swaddled and in a nest.
    That is a great idea!
  2. by   RN4Little1s
    Want to eliminate trying to be crafty with blankets, the bendy, etc? We use the Z-flo positioner, made of a fluidized material that does not have memory. It eliminates pressure point areas while providing maximum positioning abilities. Here is the website: http://www.sundancesolutions.com/neonatal.php
    You can position, nest, comfort, and contain babies with these tools. We have mattresses and long tubes. They last about 3 months as far as being good and moldable. Positioning prone is especially nice because you can create a "prone roll" by molding one and placing the baby on it, then squishing up the material so that the legs may be placed appropriately. You don't have frog legs, and there are straps to use for containment.
    To position - place the baby how you want them and then put one hand on the baby while using the other to mold to the baby. We took a class on them from a rep using dolls.

    Other than this, we have had the bendy, the snuggly, and we use snoedels too.
  3. by   Preemienurse23
    We started using the z-flow about a year ago. They are great for the micros and the ones on cpap. They don't fit the bigger kids (30wks+) very well though. And they eventually lose the ability to stay in the position they are put in. But new I like them.
  4. by   SteveNNP
    Quote from Preemienurse23
    We started using the z-flow about a year ago. They are great for the micros and the ones on cpap. They don't fit the bigger kids (30wks+) very well though. And they eventually lose the ability to stay in the position they are put in. But new I like them.
    We have both sizes, for preemies and termers...... I actually don't prefer them for the micros, as they end up looking like they are sitting on a table. I can do much better positioning with blankets.
  5. by   elizabells
    The big ones are great for the really, really sick kids. Especially the ones with wandering atelectasis, who the MDs want you to turn a different side up after every CXR. Much easier just to squish and squosh the Zflo around than muck around with blanket rolls. And if you have multiple chest tubes (ahem) you can make little divots so you can kind of put the kids on their side a little.
  6. by   babiluv
    Glad to see others are trying Z-Flo; I've worked in the NICU for many years, and Z-Flo definitely works best for positioning our babies. It takes some practice to get it right, but is well worth the effort to finally see fragile babies well positioned, comfortable, quiet, and sleeping! We use single positioners for very sick babies with multiple lines and tubes; the Z-Flo tube and smaller pad work well to contain active or agitated infants. I heard an educational video is now available from the company that shows how to use Z-Flo with NICU babies; has anyone seen it? Am hoping it might improve consistency among us, always an issue with anything new.
  7. by   Sweeper933
    Can you X-ray through them?
  8. by   babiluv
    Quote from Sweeper933
    Can you X-ray through them?
    We've done a few x-rays on Z-Flo if just for line placement, but not where air accumulation can make a difference (lung fields, KUB, etc). And even x-rays for line placement are usually examined for whatever is visible, so x-ray through Z-Flo is not our normal practice. Really sick babies are usually on a cloth (thinner than a hospital blanket) on top of the positioner, so we just barely lift the baby up and slide the x-ray plate underneath the baby and on top of Z-Flo. For nurses who think x-rays with Z-Flo are too stressful for the baby, that's not our experience. Physical disruption is minimal, start-to-finish only takes a few minutes, and babies rest so much better when well positioned on Z-Flo for all the remaining hours and minutes of the day. All our critical babies (micropreemies, PPHN, surgical, etc) are on Z-Flo. Except haven't used with ECMO, which we don't do much anymore.
  9. by   RN4Little1s
    We are not allowed to xray through the z-flo for anything. We do as PP said and make sure there is a "draw sheet" like a pillow case, to go under. We only place the head piece under ECMO kids. Also, the other flaw is babies get very ot with the plastic material it is covered with. They come with a thin cover that says z-flo all over it, but the rep said 3 layers of something (be it blankets, burp cloths) over the z-flo makes the "hot factor" go away.
  10. by   babiluv
    Quote from RN4Little1s
    We are not allowed to xray through the z-flo for anything. We do as PP said and make sure there is a "draw sheet" like a pillow case, to go under. We only place the head piece under ECMO kids. Also, the other flaw is babies get very ot with the plastic material it is covered with. They come with a thin cover that says z-flo all over it, but the rep said 3 layers of something (be it blankets, burp cloths) over the z-flo makes the "hot factor" go away.
    Temp control is one reason we need positioning consistency in our unit. A baby well contained in Z-Flo should be warmer because both surrounding air currents and infant heat loss are reduced. So turning down incubator heat output is an option, like we do if a baby is swaddled in the isolette. But if the next nurse has the baby less nested and more exposed, he might get cold and the heat is cranked up even higher than before. This problem is our technique more than Z-Flo. That said, we have had some babies get hot - - usually the incubator is still set too high (a hot topic here, no pun intended), but we will loosen the boundaries a bit. We're also thinking of experimenting with something different for the cover. If you use 3 layers of cloth, can you still mold Z-Flo enough to contour to the baby? On the plus side of keeping babies warm, we haven't used a K-pad (our "old" standard of practice) for any admission, even 23 weekers, since using Z-Flo.
  11. by   Preemienurse23
    Some of our Z-flows have to "z-flow" cover. But we usually put a pillowcase on top of it to keep it clean because it has the straps. If they dont have the cover, we usually put a blanket or pillowcase over it. Some put the z-flow IN a pillowcase, but it decreases how much you can mold the pad.
  12. by   RN4Little1s
    I think you can mold it fine even with covers. I put it in a pillow case sometimes with another cover over it. When the "z-flo" covers that it comes with get dirty, we are supposed to hand wash them because the washing machine is too rough for them.
    We haven't had any big discussion on difference in temp control in isolettes. We did find that the z-flo on top of the mattress in the isolette made for a hard to reach baby up on a big mountain through the portholes! We are allowed to take the spongy matress out of the isolette if the baby is on a z-flo inside of it if it is too tall in there.
  13. by   elizabells
    The ones I love/hate to have on ZFlo are the sick big PPHN kids. It's so comfy, especially if they're on the oscillator or something, but even with the cover on it they get so sweaty! I had one with a temp of 101 go right back down to normal after I took him off the ZFlo.

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