Gastroschisis

[littlepeach]

I was wondering if ya'll still use sterile towels or guaze initially after a delivery in the sterile bag? Recently we were told not to use anything except for the warmed saline after delivery, but were not told why. I was just wondering what your hospital did as the immediate intervention post delivery for gastroschisis.

[elizabells, BSN, RN]

As far as I know, we still use sterile gauze soaked in warm sterile saline, then the whole shebang wrapped in Kerlix and suspended from the arm of the warmer until they get to the OR.

[Sweeper933]

We use sterile gauze / warm sterile water then wrapped up in the plastic bag until they have their silo put in. Then that just suspends from the top of the warmer / ohio bed until they are closed up.

[UTVOL3]

We also stopped using the gauze wraps with the arrival of our last pedi surg. I don't think he really thought it was bad, just not neccessary. I haven't seen any research either way.

[prmenrs, RN]

We had special bags--sterile, w/a string tie to put the baby in--ob could do it before handing off if kiddo was ok. Snug up the string, and viscera stay moist while we get baby's resp stable and put in IVs, etc.

Not good to let them dry out--too much fluid loss and can damage the tissues.

[NICU_babyRN, BSN, RN]

We cut sterile drape strips/rectangles and wrap the defect in it, then wrap around with kirlex. Usually if we know there's a gastroschisis baby coming surgery comes up within the hour to place the silo, sometimes bedside surgery, but not always.

[BittyBabyGrower, MSN, RN]

We initially wrapped in sterile wet guaze with a plastic bag. We aren't siloing as much anymore, we have 2 surgeons who actually milk the defect back in the hole after evacuating the bowel of meconium (they milk it). We have cut most of our stays in half with this method. Only if there is a problem with the bowel do we silo.

[littlepeach]

Thanks so much! It's unbelievable how things change so quickly in our field. I've been NICU for almost 8 years and I learn something new every day. I love this job!!!

[lvnurs9]

We stopped with the gauze too. Just throw the baby in a bag :) They always go straight to surgery so we don't worry about drying it out or anything.