I am new to the NICU and I just recently took my NRP and I feel as though I have an ok grasp of what to do when a baby is experiencing 100% apnea but I find myself getting confused when it comes to situations such as this:
I had a patient the other day who gets "very tired" when bottle feeding and has trouble pacing so she did very well for the first bit and the pacing helped her saturations return to 100% when they would go down to high 80's, low 90's. At one point, however, her saturations kept going lower and lower until eventually they reached the 20's. By this point and her heart rate started slowing down. For some reason I decided to put her prone and "stimulate" her by gently rubbing her back- although looking back, don't know if this mattered because she wasn't experiencing apnea. I guess it was my instinct to just stimulate her to breathe more? I have no idea why I did that. And then after a few seconds of seeing no improvement, I provided blow-by oxygen and she eventually came back up and had no problems for the rest of the shift.
What would have been the proper thing to do in this situation? I kept thinking back to NRP as I saw her heart rate drop to below 100... first I thought "PPV" but then realized, she wasnt experiencing apnea and wasnt gasping. Then I thought "CPAP" because of her low 02, but I'm thinking that would be something more in the "long run"... if she kept up the low 02 for a long time and didn't come up with blow-by oxygen.
I still feel SO confused!!! Was using blow-by oxygen ok in this situation?
