Help! Infant on vent at home with pulmonary hypertension

Specialties Home Health

Published

I am working home health with an infant with pulmonary hypertension. He has regular high pressure alarms, which are solved by repositioning. Today, that wasn't the case and he was upset, though not in distress. They weren't real tolerant with suctioning, and I've read this is last resort. Mom wasn't interested in changing the trach, and just said this is normal. Is this a normal alarm for these kids?

Up Vote Up Vote ×
Specializes in Pediatric Critical Care.

High pressure alarms when upset/crying/irritated? Yes, in any baby (PH or not), when agitated then will "buck" the vent and often set off the high pressure alarm because they are fighting. Is this what you mean?

Up Vote Up Vote ×
Specializes in Pediatric Critical Care.

When you say "they weren't real tolerant with suctioning", what do you mean? Who?

Up Vote Up Vote ×
Specializes in Complex pedi to LTC/SA & now a manager.

Did you call DME respiratory therapist to trouble shoot? Did you call your clinical nurse supervisor for support?

Up Vote Up Vote ×
Specializes in Education, FP, LNC, Forensics, ED, OB.

Welcome to allnurses.com

Thread moved to Home Health Nursing forum for more replies.

Up Vote Up Vote ×

The baby started crying every time he was suctioned

Up Vote Up Vote ×

Thank you...yes. My biggest fear with hpa is a mucus clot.

Up Vote Up Vote ×
The baby started crying every time he was suctioned

Have you ever been suctioned? It's enough to make a grown human cry, never mind a baby. And, in case you didn't realize, crying in and of itself can cause high pressure alarms.

Up Vote Up Vote ×
Specializes in Pediatric Critical Care.
Have you ever been suctioned? It's enough to make a grown human cry, never mind a baby. And, in case you didn't realize, crying in and of itself can cause high pressure alarms.

The baby started crying every time he was suctioned

Particularly if you are suctioning too far. Babies with trachs will become accustomed to being suctioned (the correct distance) but yes it causes discomfort if you go too far and pass the end of the trach.

Up Vote Up Vote ×
Specializes in Pediatric Critical Care.

A trach that was occluded by mucous would cause pressure alarms but also respiratory distress and desaturation. In which case yes the trach must be changed! I wonder if they family needs some education on the correct suctioning technique and importance of suctioning when it is necessary? I would hate for them to be too afraid to ever suction when it IS needed. I wouldn't really call suctioning a "last resort".

Up Vote Up Vote ×
Specializes in NICU, ICU, PICU, Academia.

Pulmonary hypertension has nothing to do with the alarms. And no baby likes suctioning- whether it's performed correctly or not. Be certain you are using the 'safe suctioning length'. If unsure, take a back-up trach and measure how deep to insert a catheter so reach the end of the trach. My trick was to make a piece of tape this 'safe suction length' and place it on the face of the vent. Gives you an easy visual for suction catheters that are poorly marked or suctioning in a darkened room.

Up Vote Up Vote ×
Specializes in Complex pedi to LTC/SA & now a manager.
Pulmonary hypertension has nothing to do with the alarms. And no baby likes suctioning- whether it's performed correctly or not. Be certain you are using the 'safe suctioning length'. If unsure, take a back-up trach and measure how deep to insert a catheter so reach the end of the trach. My trick was to make a piece of tape this 'safe suction length' and place it on the face of the vent. Gives you an easy visual for suction catheters that are poorly marked or suctioning in a darkened room.

The tape is a great idea!!! Especially if parents want a near dark room.

Up Vote Up Vote ×
+ Add a Comment