Poor kiddo, fat necrosis sucks :(

  1. I've seen fat necrosis on some of our cooling blanket kids, but this one is the worst I have seen It goes from the top of his neck to his butt Pain meds and TLC, but he is still so uncomfortable We thought we did something wrong, but the attending from derm told us that this kid was probably so compromised that cell death was going on when we cooled him and it happens Just feel so bad. And his neuro status sucks too, so that makes it worse. Some days this job stinks
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    About NicuGal, MSN, RN

    Joined: Mar '01; Posts: 2,797; Likes: 3,178
    once a manager, now a staff nurse, preceptor, educator and practice member; from FAM
    Specialty: 30 year(s) of experience in NICU, PICU, PACU


  3. by   TiffyRN
    Sometimes I feel like all I do is barely chip away the edge of misery.

    I'm sorry, I totally understand.

    But then some days you nipple feed a former micro and they suck it down and then burp really big. That helps.
  4. by   prmenrs
    Wow! Very sad. Do you have a "pain service"--usually it's tied in w/Anesthesia? They might be able to help w/pain control.

    Go thru the "convalescing" area of your nursery to see the kids that are getting better. Might help a little for your pain.

    I'll be praying for baby, family and you!
  5. by   umcRN
    I had a baby once like that. Never actually saw it in any of our cooled babies but she came from another facility. Poor thing could barely move her arms/head at all (went all the way up her neck). When she was stable mom brought in a tub from home and we gave her warm soaking baths and then nice tissue massage on her back. Not sure how much it helped the actual tissue but she always slept really well after.
  6. by   NicuGal
    Thanks guys. Just some kids just get to you, and this is one of them. umc, we put him in the tub yesterday....really warm with lavender baby soap and he fell asleep in there...we left him there as long as we could, it had to feel so good! They are thinking they might have to do a biopsy on it, the one area looks funny and they are afraid it is going to abcess under there. I hope they don't have to because that would end the baths as it takes a long time for that to heal and it will drain a lot. They told us it can take up to 6 months for this to resolve His one shoulder looked a bit better last night, but the area by the neck is really bad. It looks bad where all the brown fat would be I just feel so bad for this family, his outlook doesn't look great Ugh. We give a half dose of morphine before therapy and any extensive care and we can give Tylenol too if we need. Just one of those kids that just breaks your heart because you know his future is pretty dim
  7. by   umcRN
    The ones that get me are like one we have right now - SMA diagnosed shortly after birth. You look at him and he can move his eyes and you can tell he's in there but he doesn't do much else :-(