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HOB elevation

NICU   (2,050 Views 6 Comments)
by NJNICUCCRN NJNICUCCRN (New Member) New Member

NJNICUCCRN has 23 years experience .

1,550 Visitors; 31 Posts

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Our NICU is looking for a product to recommend to parents when babies are sent home with the HOB elevated. Has anyone used a wedge or riser under crib legs that they feel is safe and effective?

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dawngloves works as a NICU RN.

11,405 Visitors; 2,399 Posts

The AAP does not recommend elevating the HOB for infants. Not even those with reflux.

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Coffee Nurse has 10 years experience as a BSN, RN and works as a Staff nurse.

12 Likes; 16,303 Visitors; 922 Posts

"Elevating the head of the infant's crib while the infant is supine is not recommended. It is ineffective in reducing gastroesophageal reflux; in addition,it might result in the infant sliding to the foot of the crib into a position that might compromise respiration." AAP, 2011.

http://pediatrics.aappublications.org/content/pediatrics/early/2011/10/12/peds.2011-2284.full.pdf

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NJNICUCCRN has 23 years experience.

1,550 Visitors; 31 Posts

I didn't mean to write a lengthy post but....

I am well aware of the AAP guidelines on safe sleep environments. In my 30 years of level 3 NICU experience I have seen just a handful of babies go home in elevated, prone positions for sleep. Not just for reflux but for airway management of conditions like laryngomalacia or Pierre robin syndrome.

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MNNICU, RN works as a NICU RN.

2,102 Visitors; 60 Posts

We too recently had a head cooling baby that was pretty brain damaged and had a hard time handling secretions. He would turn blue and desat as soon as he was laid flat so he went home on a wedge. I'm not sure the brand or anything our OTs handle ordering them.

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BittyBabyGrower works as a Nurse of course!.

1 Like; 12,608 Visitors; 1,823 Posts

We have had Neuro kids go home elevated. Our OT/PT set up some sort of wedge for them.

As we all know, there is always an exception to every rule. Neuro kids, trached kids are just a few.

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