Sensormedics

[Julie Basilio]

How frequent do you change the position of babies on Sensormedics?

[dawnebeth]

I don't know what a sensormedic is, but we try to change the baby's position every two hours, if at all possible. If not, then every four to six, making sure to check pressure areas like buttocks and ears more often. Use of gel pillows, positioning aids like bean bags and blankets can be used to prop the body into sidelying position even if the baby isn't moved completely more frequently.

[DesertwindRN, ADN, RN]

You are "clustering" cares every four hours? If the infant is "hands on" every four hours, then that is the time to change position if the infant is tolerating position change every four hours and not restricted due to complications.

Sometimes you run into nurses who are afraid to position change with a HFV, which is just wrong.

I cared for a little one who had not had his position changed at least during the past twelve hours. His head was so awful to see for his poor parents and I could not help but think of the pain he was in. (His IV had not been replaced that infused his pain med and that had been off more then four hours when I came on) He looked just awful when we took him off the vent to be held in his parents arms for the first and last time with one side of his head flat and black and blue that same night.

I think you should check with your charge nurse or someone experienced you can utilize for a resource as to the policy regarding position changes in your hospital for care of infants on HFVs. (Better answer)

[DesertwindRN, ADN, RN]

Just remembered that only one facility I worked at had this adapter on that stiff tubing of the sensormedic that allowed for ease with the position change--------did not have to do a complete turn around to turn the infants head------what a difference. The RTs at the other facilities did not understand the adapter when I described it in the hopes that it could be ordered because it made such a difference-----so without that adapter it often was such a production that it was a two person job unless the nurse was very experienced and this often made it a six hour position change-------you just have to think it through so it is smooth and quick-----with experience it becomes as with all skills so much less stressful to the nurse giving the primary care. Some facilities will have a policy stating that this is a two nurse skill so be sure to check the policy. There are very experienced nurses who will be more than happy to assist-----RTs can be helpful as you get to know which ones have the experience and the care to assist with your patient-------this is part of the NICU------protecting your patient and assessing each person who has to touch your patient------another topic. I know sometimes it is so hectic that it is hard to ask for help, but you just have to until you are comfortable with the skill needed for the care of your patient. You will get to know which nurse you can ask for help who will be glad to help because she cares about that little patient too.

[dawnebeth]

Oh, yes, with a High Frequency vent, we always have an RT help to turn the baby because of the stiff tubing. Usually every 4 to 6 hours. On rare occasions, if the RTs are insanely busy, I do know how to do it myself, but that is courting disaster if the baby extubates, so it is far safer to have an RT help turn the baby. Unless contraindicated by atelectasis or a head surgery, the babies should be turned as often as possible.

[DesertwindRN, ADN, RN]

Not all RTs are created equal and you have to know who you are working with before asking for assisitance, expecially when working with Sensormedic Vents. Some are just awful to work with, some do not "get it". Some do not want to help. Some cause more problems ----- some are worth their weight in gold. Part of being a NICU RN is protecting you patient--------a huge part. But again I would check your unit's policy. After working as a traveler and an agency nurse I know that what one hospital expects can greatly differ from another. Some have EVERYTHING written in blood and there is only one way to day a particular skill and they are not open for new information and you just have to know what they want and how they want it done. You learn to ask the questions and quickly find the answers.

I am comfortable caring for and making the position change on a sensormedic patient without help, but one of the hospitals I work for via agency has a policy that this is a two person skill. I know who to ask to help and I am very careful who assists me with these patients.

[Julie Basilio]

Thanks alot for your inputs! In our unit we usually ask the RT on duty to help us. I just post this to know how you are doing in our facilities. We do turn our babies of Sensormedics every 8 hours... We are not as well equipped as you guys...Our fear in Sensormedic babies is the possible development od pressure sore. But I guess 4 to 6 hours is more reasonable. We have one case of pressure sore in the post auricular area. It is improving dramatically. Just so sad that after a year...it our first case again. Baby is with ascitis and generalized edema and on Sensormedics. We dont have bean bags or those pillows used in turning patients. What we are doing is improvising a water bed made up of water filled gloves ... and I guess it really helped us with babies on Sensormedics and Chronic babies. Though we were not able to prevent the occurrence of sore, I guess will try to suggest that turning will be more frequent as much as possible. Thanks alot fro your help!

[NeoNurseTX, RN]

Q4h like everyone else (that is NPO anyway).