My First "Bad" Baby!! - page 3

Just wanted to share my experience with you all because it was my first and who else understands me better? We had an emergency C-section the other night and I was the one going to the OR. The... Read More

  1. by   fourbirds4me
    Sounds like everything turned out great! I have some questions though.... Did you use an ET tube to deep suction/view cords before you started stimulating?
  2. by   Gompers
    Quote from fourbirds4me
    Sounds like everything turned out great! I have some questions though.... Did you use an ET tube to deep suction/view cords before you started stimulating?
    I was wondering about that, too. I thought that if a meconium baby was crying already, then you just regular suction and all that. But if the baby is limp and not breathing, you intubate and deep suction before stimulation.

    Of course, as nurses we are TAUGHT how to do that, but we aren't ALLOWED to do it! There should have been a doc or NNP in the room who could have intubated for the deep suction.

    So glad the baby did well, though! Those are great moments!!!
  3. by   fourbirds4me
    Quote from Gompers
    I was wondering about that, too. I thought that if a meconium baby was crying already, then you just regular suction and all that. But if the baby is limp and not breathing, you intubate and deep suction before stimulation.

    Of course, as nurses we are TAUGHT how to do that, but we aren't ALLOWED to do it! There should have been a doc or NNP in the room who could have intubated for the deep suction.

    So glad the baby did well, though! Those are great moments!!!
    Why aren't you allowed? We are allowed but most nurses so scared of it they rarely do it and instead drop a delee or a 10fr... although these are just suctioning throat and stomach. I myself am scared of NOT doing it because of guidelines and what if a case went to court.... "Why didn't you view cords/ intubate"... I'm so not ready to answer that one. So I always set up to do it and pray for a vigorous baby
  4. by   Gompers
    Quote from fourbirds4me
    Why aren't you allowed? We are allowed but most nurses so scared of it they rarely do it and instead drop a delee or a 10fr... although these are just suctioning throat and stomach. I myself am scared of NOT doing it because of guidelines and what if a case went to court.... "Why didn't you view cords/ intubate"... I'm so not ready to answer that one. So I always set up to do it and pray for a vigorous baby
    Well, it's kind of along the lines of a discussion on ACLS that I read here earlier this week - many adult care nurses take that course but never intubate patients in practice. You learn it as part of a course, but to actually do the procedure you really must gain clinical experience before you can just start tubing people. Intubation is taught as part of NRP but I think depending on where you are, nurses may or may not actually get to do the procedure. If you never get to do it, you really aren't competent enough to just try it someday, IMHO. In some hospitals I'm sure nurses intubate, but in the ones I've worked we never do. It could be that I work in a big city with lots of teaching hospitals and the like. We NEVER NEVER NEVER go to a high risk delivery without a neo doctor or NNP. So why would we ever intubate?
  5. by   mother/babyRN
    Wonderful you guardian angel you! Bad babies are scary the first time and the thousandth time. WAY TO GO!
  6. by   Darchild77
    as to regards of the ET tube, the CRNA is the one that does this. at our hospital nurses do not intubate, so I used the 10 french method until the crna came over to use the ET tube. And BTW, the crna got his *** chewed for leaving his patient(the mom), so he turned on me and told everyone that I froze!!!! kinda ruined the whole experience for me, now everyone really thinks that I froze!!!!!:angryfire Now i'm just embarrassed
  7. by   suzanne4
    And who was it that chewed the CRNA for leaving his patient?
    Where was that person when this was going on?
    And who went after the peds doc for being late?

    For those of you that are not aware, a baby this is "overdo" can be much more dangerous than a baby who is a preemie. Meconium is thick and tarry and I have seen too many of these babies have big problems. We used to get them for ECMO at one of the facilites I used to work at in Phoenix every so often. I am much more afraid of having problems with a meconium baby than I am with a 500 or 600 gram preemie.

    You did a good job but you should not have to shoulder the blame for doing the appropriate things with the resources that you had availalbe to you.
  8. by   suzanne4
    Quote from fourbirds4me
    Why aren't you allowed? We are allowed but most nurses so scared of it they rarely do it and instead drop a delee or a 10fr... although these are just suctioning throat and stomach. I myself am scared of NOT doing it because of guidelines and what if a case went to court.... "Why didn't you view cords/ intubate"... I'm so not ready to answer that one. So I always set up to do it and pray for a vigorous baby
    Your hospital allows you to intubate a neonate? Or this is something that you learned in NRP? There is a big difference.......................if it isn't in your Policy and Procedure book, then you are not allowed to do it. If you did do it, and there was problem you would have trouble on your hands. And if you were going to intubate to visualize cords, do you actually know what you would be looking at? Have you actually done it? It looks very different on a human baby than one of the mannekins. :uhoh21:
  9. by   fourbirds4me
    Quote from suzanne4
    Your hospital allows you to intubate a neonate? Or this is something that you learned in NRP? There is a big difference.......................if it isn't in your Policy and Procedure book, then you are not allowed to do it. If you did do it, and there was problem you would have trouble on your hands. And if you were going to intubate to visualize cords, do you actually know what you would be looking at? Have you actually done it? It looks very different on a human baby than one of the mannekins. :uhoh21:
    Not only are we allowed to do it.... we are expected to do it. I have not acutually done it but many of our nurses can/do. I have seen more that one doc who had trouble doing it also so I don't see that as a problem inherent to nursing. We do not have a ped in house and many, many, many times the need for intubation is not apparent until at or near delivery. Of course in the case of resuscutation as long as you are moving air with bag/mask you can wait but otherwise......

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