Any 22 weekers out there?

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Specializes in level 3 NICU.

last night in our level 3 unit, out team with over to l&d for a code. it was for a 22 and 3/7 weeker! they coded that poor kid for 50 mins:mad:. has anyone ever heard of this? has any one taken care of an infant under 23 weeks and it lived even an few days. after 26 years somedays i just wounder what is next. how low can we go?!:confused:

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We had a 22 weeker on our unit for a few days, I work in a Children's hospital so it came from an OSH...i'm surprised our docs agreed to take it although I think the reffering hosp said it was 23 weeks...under 500 grams though, eyes fused, completely see through, K+'s were through the roof and electrolytes all over the place....we just couldnt keep up with her and she did pass...during a code with her mother watching and screaming that we had to save her baby :-(

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Specializes in Nurse Scientist-Research.

A couple of years ago there were two sets of sextuplets born close together (in time) but different parts of the country, one set was much further along and did well from what I heard. The Morrison sextuplets only made it to 22 weeks, I can't find all the information but from what I remember, they were pretty sure on the dates. Only one infant survived to discharge. The last update I read (almost 3 years ago), he was doing "fine". I would love to have a more recent update.

The Morrisons Talk About Losing Their 5 Babies For The First Time : Growing Your Baby

To my knowledge during my time in my busy unit, we have resuscitated very few

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Specializes in NICU, PICU, educator.

Depends on the month..if it is 500gms and gasping, it is coming back :( Sometimes less than 500gm and twitching and we'll take it. Then we proceed to basically torture these kids for 6 months or so, if they make it that long, and then they PPHN, get put on nitric, and then die. I hate it. Just because we can, doesn't mean we should. I wish the docs would grow a pair and be up front with these parents, esp once the kid has a big bleed, a black gut and skin peeling off, and just say, there is nothing else we can do, we will give your baby morphine and let you hold him so that he can pass away in your arms. yeah. That is my dream world.

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Specializes in level 3 NICU.

dear bittybabygrower, i agree with you so much! i keep seeing this same situation over & over. it is just so sick to touture these kids! and if i hear one more parent say "he is such a fighter" i am going to scream, he has no choice or voice to say "stop the touture! "also, getting the ethics committe involved is a joke because they are afraid of the docs.

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Specializes in NICU.

We had a 22 weeker this past week. It was soo sad, you could tell the baby was suffering...along with the parents. My hospital usually calls the ethics committee and discusses this situation, but I don't know what happened this time. As a general ethics rule, my hospital, normally doesn't resuscitate any baby born less than 23 weeks. Upon a HUS, the baby had extreme head bleeds. The baby passed away later that night.

In defense of the parents, they fully don't understand that their baby is suffering or that their baby is not compatible with life or how severely they are undeveloped...we ask if they want us to resuscitate the baby at delivery, but the only thing they're thinking is, "you're not going to save my baby? that's why we're at a hospital!" ...tough situation. no baby should suffer :(

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Specializes in L/D 4 yrs & Level 3 NICU 22 yrs.

The healthcare team should stop asking the parents if they want everything done to save their baby. The team should tell the parents that all that can be done is to provide comfort care and let the parents hold. Choices such as coding with chest compressions, bagging, and meds should not be offered. Until the team steps up and offers a humane and dignified scenario, we, the NICU nurses, will have to continue to fight this battle for the babies.

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Specializes in MSN, FNP-BC.

I'm going to preface this with...........I have not taken NRP yet. I take it in October.

Aren't there guidelines in NRP for resus such as GA and weight?

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Specializes in NICU, PICU, educator.

In the NRP world, yes, in the real world...not always is it followed. We will code a kid in L/D for an hour when there is nothing to code...NRP has guideline for that too. But the reality of it is...one, docs fear lawsuit, two, sometimes they just don't want to not do anything, ego, what have you.

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Specializes in NICU Level III.

We had a 22 weeker live about 2 weeks before it crashed and burned.

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The healthcare team should stop asking the parents if they want everything done to save their baby. The team should tell the parents that all that can be done is to provide comfort care and let the parents hold. Choices such as coding with chest compressions, bagging, and meds should not be offered. Until the team steps up and offers a humane and dignified scenario, we, the NICU nurses, will have to continue to fight this battle for the babies.

I know someone who worked as a NICU nurse in the UK. That person's experience is a lot like you described. The docs would talk to families about their wishes, but ultimately the medical team didn't hesitate to draw the line where they felt appropriate.

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I cared for a "grown-up" 22wkr the other night. Some of the other nurses and I were talking about what a sick baby he was and how many times he almost passed. He is doing so good now! PO feeding exclusively! He managed to avoid severe bleeds and ROP. He's on a good bit of oxygen and diuretics and pepcid for reflux. He's amazing! I reminded myself of that the SECOND time I had to change scrubs due to the reflux.

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