Answers about asphyxiation anyone????

Specialties NICU


OK NICU nurses, I need some help. Infant with nucchal cord x2, severely asphyxiated at birth. I have him on Day 4 of life. He is extremely floppy, decreased tone, no gag, no reflexes period, and he stops breathing and the bag and mask comes out. The day I had him, it was 7 times the night before and 4 times for me before we gave him a NC. This is complete apnea and desats to 30-40%. I'm a new grad, so of course I was with my preceptor. I was told the outcome for this child is very grim, severe CP, probably eventually trached and on a ventilator, if they were to go that route. I guess many questions have come up in my mind regarding this situation. What will eventually happen to this child? Is it just a watch and wait? Can a child this young become a DNR? I dont know, its just so sad for me to see that this perfectly shaped and beautiful child may not have a great future. Is there any hope?

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VivaLasViejas, ASN, RN

108 Articles; 9,984 Posts

Specializes in LTC, assisted living, med-surg, psych.

How sad, Calla! I wish I had some words of wisdom for you, but I don't......all I can say is, the parents are really the only ones who can make decisions for the baby. His prognosis sounds grim indeed, and in time you'll learn that sometimes it's best to let nature take its course, that God has His reasons for things even though it doesn't make sense to us at the time.

For now, the staff and the baby's doctor need to sit down with the parents and talk about the options, if they haven't done so already. It's a heartbreaking situation, and there are no winners---even if the baby does live, there will likely never be anything remotely resembling quality of life for him. Your job is to support the family in their decision without regard to your own feelings, and to care for that child as you would any other. In the meantime, you might want to speak with your preceptor or another trusted advisor, both to vent and to help you figure out how best to deal with the situation.


Mimi2RN, ASN, RN

1,142 Posts

Specializes in NICU.

I agree with mjlRN, not a good prognosis for the baby. Sound like a case for the Ethics Committee if you have one. Also a family conference may help. The family may not know about the possibily of a DNR.

Just from what I've seen, in most cases the parents will go the whole nine yards and this child will be d/c'd home with a miriad of issues. Really really sad.


43 Posts

Poor little guy! A lot of the time, I don't think that the physicians explain that making your baby a DNR is an option. I was told by a nurse where Zoe was hospitalized that they will do everything in their power to rescesitate even a 24weeker regardless of the parent's wishes. I wasn't told that taking Zoe off life support was an option until she was REALLY ill...The last time she coded, she needed defibrilation 6 times to get her little heart going again. The doc THEN told me that he thought we should stop cardiac meds and the vent. I obviously asked about prognosis, and he said most likely severe brain damage, if they could keep her going until her kidneys started working again...Sigh, I just think that the NICU docs keep parents in the dark when it comes to the "scary" stuff.



1 Article; 2,334 Posts

Originally posted by dawngloves

Just from what I've seen, in most cases the parents will go the whole nine yards and this child will be d/c'd home with a miriad of issues. Really really sad.


I've spent half my career taking care of these babies at home.

Until the parents know their options or until the Neonatologists "give up" things will continue as they are.


82 Posts

am taking care of a baby right now with the same issues....on day 6 still no options for the mother.....I gave her some myself....if the doctor is too lame to talk to her...I answer her questions.....she thanked me for giving her something to think about since no one else would....sad

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