Quote from tictac
They did say the ETT must have been sitting very high because there was a 1.5 cm difference in depth with the new one. This baby was just over 1 kg and I believe it had been 2 weeks since the last chest X-ray. .
There's the problem. Most NICU's do a daily X-ray to check for ETT placement.
When the ETT is inserted, you need to check in report for the following:
1. The date of insertion.
2. The measurement documented at the lip.
Every time you assess the baby, you need to check to make sure you see the same mark. The first few times you turn a baby on a ventilator, move slow and have respiratory therapy right there in case something happens. It takes practice and I was shaking so bad the first time I did it I thought I was going to die. After a few times I was able to do it on my own.
Your #1 priority is watching the ETT tube and any lines to make sure that they do not pull. It takes practice.
I would get my baby "straight" and organized before I started turning. I also made sure I had a visual and within easy reach the mask and the CO2 detector.
Don't worry, the first time a baby extubated on me I literally froze with fear. They are very serious, it happens to everyone.
The fear comes from not knowing what to do. When you learn what to do, you will react to it like anything else that you fully understand.