Preemie resuscitation in regards to gestational age

[d2k2]

Hi everyone,

I've been a lurker here for a few months. I have learned so much! Thank you to everyone for sharing your knowledge, opinions, outlooks, and advice. I am an RN hopeful, probably graduating around 2010!! :wink2:

I am doing a research paper on preemies and their gestiational age. Of course it's the controversial question of: "When are they just born TOO early?"

I would love to hear opinions, ideas, and what your hospital practices in regards to when preemie babies are or are not resuscitated. Does your hospital go to all lengths? Or is there a "cut off" as to when they don't even try? And what is your personal opinion about it? Any information would be so greatly appreciated! :kiss

If this thread is already somewhere else on this forum, I'm very sorry! I did look and didn't really find anything.

Thanks in advance!

d2k2

[dawngloves, BSN, RN]

I recommend the book, Saving Very Premature Babies by Pauline Challinor Mifflin.

http://search.barnesandnoble.com/booksearch/isbnInquiry.asp?userid=MA0VFURC65&isbn=0750654120&itm=1

Some good perspectives on saving the micro-micros

[Sweeper933]

I work in a Level III NICU in the Chicago suburbs. Our general policy is that we will resuscitate any baby > 23 4/7 weeks. The docs of course have long talks withe parents regarding outcomes for 23 weekers, and it is always the parents say whether or not anything is to be done. We just had a former 23 4/7 weeker go home at gestational age of 38 weeks, no ROP and IVH/PVL. Our outcomes aren't always that positive, but we do have several other former 23 weekers that have gone home with out too many long-term problems. In the past few years, our unit has come up with a great policy regarding initial care with

[rainbows4me]

In the past few years, our unit has come up with a great policy regarding initial care with

Care to share?? Would love to hear what other units are doing specifically. On our unit, micros come up in a plastic bag (like those cooking bags for the oven), stay with head in a neutral position for 1st 72 hours, use giraffe beds or bed scales, keept O2sats

Rainbows

[Gompers, BSN, RN]

Care to share?? Would love to hear what other units are doing specifically. On our unit, micros come up in a plastic bag (like those cooking bags for the oven), stay with head in a neutral position for 1st 72 hours, use giraffe beds or bed scales, keept O2sats

Rainbows

Hmmm...we don't have a protocol per se, but maybe we should. I like the idea about keeping the head in a neutral position and starting protein right away. We just have them on D5W for the first 12 hours of life.

[dawngloves, BSN, RN]

I have been hearing more about others starting HAL ASAP, but we don't. We also do the "turkey bag' Real PITA. We keep our

What is this about keeping the head neutral?Something to do with bleeds?? We get a head u/s at 24 hours.

[Sweeper933]

Care to share?? Would love to hear what other units are doing specifically. On our unit, micros come up in a plastic bag (like those cooking bags for the oven), stay with head in a neutral position for 1st 72 hours, use giraffe beds or bed scales, keept O2sats

Rainbows

Our unit currently only has two giraffe beds (darn beds are awesome, but SO expensive!). When we know that we are getting a

Sorry to kind of ramble on a bit about all of this, I tried to pick out the highlights from our protocol. The biggest thing on our unit right now is keeping these little guys warm - hence keeping them on the same bed during transport instead of transfering to and from the transporter we use for the bigger guys. The saran wrap and high humidity have also seemed to help a great deal as well.

Hope this helped!

[suzanneuthscsa]

I had a preemie at 24 wks exactly that weighed 442 g. That is pretty close to that cut-off. He was born in 03-2000. I want to brag and say that did beautifully. He has no major health issues now. He wears glasses and has some chronic BPD. He never had an IVH or NEC although we did deal with a pneumothorax, chest tubes, and an oscillating ventilator. Many times the docs and nurses discussed how far we wanted to go. I did not want him to needlessly suffer, but while there was still a chance at a normal life I didn't want to give up. Boy, am I glad now. He went to the doctor twice last year and if you discount his eye appointments and once was a routine check-up. From what I have read, 23 wkrs are making it a lot more frequently now. At the hospital he was at the dr told me that 1 in 100 23 wkrs made it and that was nearly 6 yrs ago. Hope this helps in your research on a subject near and dear to my heart.

Suzanne

[judyblueeyes]

Our guideline is 24 weeks and/or 500 grams, but we are flexible about it depending on the family and the baby. We are a specialty hospital and deliver about 8500 babies a year, a large number of which are premature because of the nature of our services. Our NICU has over 100 beds and the highest census was 136 fairly recently.

My own son was 23.5, 700g, now 8, with no residual physical problems (nl ht, wt, no asthma, glasses or allergies).

He does have Asperger's type autism, but is very functional. Most folks wouldn't notice that he is any different from any other kid unless they see his scars. Of course, he's had lots of therapy and still get three therapies (OT