Week from Hell - page 2

Okay - I am a recent grad and have been on the job in a Level 3 NICU for 6 months. Most of that time was spent in our Level 2 nursery. I functioned independently for about 3 months handling 4... Read More

  1. by   MA Nurse
    Quote from elizabells
    Our ECMOs are usually rock stable unless it's cannulation/decannulation time or they've decided to seize or go into SVT. Also since we barely sedate them at all, sometimes there are tense, hold 'em down while someone runs to they Pyxis moments.
    You barely sedate them at all?! That's not good medical practice to have a baby on ECMO not sedated. They should have a drip of some kind to keep them calm, or Q4 ATC sedation.
  2. by   elizabells
    Quote from Kimbalou
    You barely sedate them at all?! That's not good medical practice to have a baby on ECMO not sedated. They should have a drip of some kind to keep them calm, or Q4 ATC sedation.
    Dude, I hear you. There's a reason I get called the "druggie nurse" and why the perfusionists are always happy to see me. The rationale (and I'm not saying I agree with it, just saying what it is) is that continuous sedation makes it more difficult to monitor for seizures, and that sedation increases V/Q mismatch, which is like the biggest drama on my unit. My feeling is that the kid's not going to HAVE a neuro status to monitor if they decannulate, and nothing makes worse V/Q mismatch than bucking the vent. The attendings can be as mad at me as they want for "oversedating", but they'd be a lot madder if the baby exsanguinates.

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