Deep suctioning babies after delivery

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Specializes in postpartum, nursery, high risk L&D.

after reading the thread on c/s babies with frothy sputum I'm curious exactly how other nurses do this. I just recently finished orienting on L&D and I've gotten conflicting information and seen it done differently by different nurses.

thanks!

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

What you need to do is know your specific policies/procedures regarding newborn recovery/care after delivery. Each place does things differently. If you have a CNS or NNP on staff, that person is an excellent resource to ask, also.

Also, if you have not had NRP (neonatal resuscitation program), you need to get working on that ASAP. Most places, it is a requirement for employment, anyhow. GOOD LUCK TO YOU!

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Specializes in postpartum, nursery, high risk L&D.

unfortunately our policy/procedure for newborn recovery doesn't get that specific, I mean as far as detailing the actual suctioning procedure. When I work next I intend to ask our Nursery Guru what the norm is, but while I was reading the other thread, like I said, I was just curious about the way it's done other places & by other nurses.

The way I was taught when I first started doing mom/baby a couple years ago (at a different hospital) was with an actual DeLee suction catheter, and my preceptor was very emphatic that you need to make sure to pass the catheter far enough to suck the gunk out of the baby's belly. The other day I was the RN at a vag delivery, and the baby was pink and crying but just seemed a little grunty and sounded "juicy" to the other RN who had come to recover the baby. She used a regular little 8fr suction catheter and just suctioned the back of the baby's throat and each nare. My thought was, how would that be much more effective than the bulb? but I didn't get a chance to ask her about it after the delivery (busy night that night)

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The suction catheter can get further down that the bulb syringe.

Do you have a clin spec you can bring this up to?

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Specializes in postpartum, nursery, high risk L&D.

yep, I intend to. I was just interested to know how things are done elsewhere.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

We use a DeLee w/a sputum trap, attached to wall suction, set at 60-80mmHg pressure and suction in mouth and nares, if needed. It's a good idea, to have "blo-by oxygen" at the face when doing this. A 2nd nurse can hold the O2 to the face as you suction. BE VERY judicious in suctioning, esp the nares. Make as few passes as you need to get the job done.

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Our docs are really clamping down on the use of blow by O2 unless the sats or baby's colour indicate it's needed. We also use a wall suction system, usually with just a regular 8Fr suction catheter.

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Specializes in ER, NICU, NSY and some other stuff.

A suction catheter as stated previously gets the stuff further back than a bulb can.

A couple of points though. Keep each attempt brief. Only activate teh sx after you drop the catheter. Keep your attempt brief, don't continually sx for more than a few moments at a time so the baby can get a breath in. Pass the catheter as few times as possible. Multiple passes can casue irritation and swelling to the nares.

Hope this helps.

We typically used just an 8 fr sx catheter.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Funny how practices differ so everywhere. Our NNP is still recommending blow-by.

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Doc's restricting blowby? thats strange where I work the docs dont even touch the baby. I was teaching a patient about GBS profalaxes the other day and asked the doctor about statistics (not becuse I did'nt know but to involve them in the conversation) The doc did'nt know.

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Doc's restricting blowby? thats strange where I work the docs dont even touch the baby. I was teaching a patient about GBS profalaxes the other day and asked the doctor about statistics (not becuse I did'nt know but to involve them in the conversation) The doc did'nt know.

Fortunately our docs are more hands on than that. I would hate to see a neonatologist who doesn't even touch the babies at deliveries :confused: The new NRP guidelines are coming out with less support for giving O2 as much as we always have. If I hear the words "free radicals" at one more delivery I swear I will scream, but I know that's just the dinosaur anti-change side of me...;) .

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Our docs are blow by junkies. Dusky hands and feet at one minute?? Blow by!!!

But I don't think a couple of minutes of blow by would do any damage.

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