When we admit the little 22-25 weekers, we have a "rule" (Don't think it's written protocol) to leave them supine with their head midline for 96 hours to prevent IVH.
Unfortunately, not everyone does that, (I don't know why) and some of our newer nurses have even heard of that (a problem with education/orientation).
The reason I ask is because I'm writing an EBP paper on this to complete my BSN.
I'm also having trouble finding solid research on this, does anybody know of any good studies and articles on this topic?
I appreciate the insight. I'm new to the forum, very interested to see what everyone is doing in their neo worlds!
We do 72 hours with the head midline. One thing I have found, though, is that a lot of nurses think the head can only be midline while supine, and not prone or side-lying. I don't know why they believe this, but they do.
How is it even possible to do prone with the head midline?
I'm starting some work on IVH prevention protocols in my unit. Something I haven't seen addressed yet is how (or if) to do skin-to-skin with these babies and maintain midline positioning. Does anyone have insights to share? I'm thinking about babies at the upper limit of these guidelines, say 28-32ish weekers, stable on bubble CPAP, peripheral IVs only, -- not 23 weekers on the vent with lines.
We place them in side-lying position against the parents' chests.
We place them in side-lying position against the parents' chests.
Thank you! I'm still new to NICU, and work on a unit where no one practices keeping midline and many haven't heard of it. ("Just put him prone" is the answer to any problem.) Relying on you all for help because there is so much I haven't seen. I will try this next time.
We will get our ELBW infants out for SSC while on a vent, but not with a UAC. CVL's are ok, We don't have a strict policy for our 23-26 weekers regarding midline head positioning but its generally practiced and encouraged. No prone positioning while UVC or UAC are in place. We're really careful when bringing them out of the incubator and it generally needs 3-4 people and lots of tape! We usually wait a week or so before getting them out and want some stability so that usually means no HFOV or Nitric.
champagnesupeRNova
166 Posts
How is it even possible to do prone with the head midline?