I floated to NICU and my pt got NEC and likely won't survive. I have to float to NICU frequently (usually once a month) but we typically get feeder/growers assigned to us.
I feel like I caught the symptoms early, but OMG, it was lightning fast and really sort of shocked me! I don't shock easy and have had pts go south quickly in PICU, but this was like: healthy/stable baby, to dying in just a couple of hours!
I don't think I 'missed' anything, but I can't stop worrying maybe if I'd caught it just a bit sooner, her outcome would be different.
The only symptoms started in the afternoon: a little tachy (she'd been 160-170's all day, and jumped to 180's) and her belly was starting to become distended. She was stooling, active bs, not tachypnic, she was on 21% @ 1L and sat'ing 100% all day. Normothermic all day. She'd just had 2-2.5ml residual before feeds and then when she got symptomatic it was 6mls.
By the time I left she was on an oscillator, had a picc and working on an artline, and putting in drains at the bedside. I gave prbc's and ffp, and had orders for cryo, and more prbc's. Her gases were crap. They were about to start pressors.
What kinds of things do you see before they get NEC? What might I have missed? I've taken care of all kinds of awful stuff (kids beaten into a coma, drowning, heart surgery kids, traumas...) but this has me rattled
