NICU Cribs/Beds

[nickirnak]

We are looking for good options for a crib in the NICU for our larger patients. We often have kids that are >4.5kg & no longer fit the radiant heat warmers, but the floor cribs do not have scales or sides that easily come down, making intubated/trached kids hard to manage in these cribs. Does anyone have ideas? Use a crib that works well for this population?

[NICUmiiki, DNP, NP]

We put our low acuity, temp-stable, kids into those cribs in the first post as soon as they're ready, but the ones we have are too small for our bigger kiddos. We put our large/chronic sick kids (lines/vents/trachs/etc.) into these big cribs by Stryker. We keep all 4 of the rails down flush with the edge of the bed, and make a little half moon shaped nest to keep the babies from sliding down the HOB which is kept elevated. Works great for us because it's super easy access to the airway or any other lines/drains.

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You keep the rails down? Can you elaborate a little further? I can just imagining one our bigger babies wiggling his or her self right onto the floor. I've had babies turn sideways in the bed with their legs swinging through the rails, if the rail was down... Well, I'd be fired.

[adventure_rn, MSN, NP]

You keep the rails down? Can you elaborate a little further? I can just imagining one our bigger babies wiggling his or her self right onto the floor. I've had babies turn sideways in the bed with their legs swinging through the rails, if the rail was down... Well, I'd be fired.

Probably not your intention, but your comment made me laugh out loud. It's like when you pull back an isolette cover to find your 31-weeker upside down in the bed, sound asleep with her face smooshed up against the porthole. Like, 'Really?? How did you even do that???'

[BrandNewBabyNurse]

Haha well I should've clarified further. We only keep the rails flush if the kid is nested and (usually) sedated. When we have a really big kid, like 6 mos- 1 yr, who is maybe alert and more developmentally advanced, then we keep the rails up halfway (which is plenty to keep them safely contained.) The kids who have the rails down are sitting in a pretty deep blanket nest, and for one reason or another are not at risk for being able to flip themselves out of it :)

[Julius Seizure]

We keep the rails all the way down sometimes, but pretty much only on medically paralyzed kids, ECMO kids, etc. If they are intubated, rails are generally half-way up. (Most of our kids are bigger though).

Wanted to mention that one of the cool things about those Striker cribs to me is that the top 1/3 and bottom 1/3 of the side rails can swing open separately without lowering the rail. Useful when you need to get to something but down want to wake the lightly sleeping baby by lowering the rail.

[nickirnak]

Thanks everyone! Sounds like someone needs to invent a good NICU bed for these kiddos. We are starting a remodel that will increase our room sq. footage so will allow for bigger beds, I feel like there still is a big gap between the NICU warms/beds vs. the large Stryker PICU cribs.

[prmenrs, RN]

I looked @ the Hard site for neonatal cribs, which they did have: Hard Manufacturing :: NICU

[Lyfling83]

This is the crib we used for our bigger babies. All four sides can go down. If baby is on an oscillator the head crib rail can go down so it can connect unimpeded. The HOB can elevate by cranking the handle. The whole bed doesn't go up and down but it works for most everyone. We stored diapers, wipes, and linens underneath and covered them with a sheet or quilt. I have had pretty big babies in these, up to like 6 or 7 months. So they work pretty well for a range of babies.