Holding an intubated baby with a UAC

Trauma Columnist · May 18, 2008

I can offer no advice but just wanted you to know what a wonderful nurse you've become! You are so compassionate and loving with these itsy bitsy patients. In the years you've been here, I'm sure you have been such a blessing to these poor parents. Have a nice day.

allnurses Guide · May 18, 2008

I used to work in a PICU and we did let our parent hold their intubated babies if they were stable.

We would sit the parent in a chair and with plenty of help around do a quick transfer over to the parents arms then secure the ETT in that position.

As far as the UAC, make sure it is well secured and just take care when you transfer.

Sabby_NC · May 18, 2008

Hey guys!
So I have this baby right now with prenatally dx'ed dilated cardiomyopathy, at our hosp for transplant eval. She's really little, only 2kg, so I have a feeling her chances of getting a heart are slim. She's really quite stable, but intubated with a UAC. I'd really like for mom to get to hold her at some point, but our unit doesn't usually allow holding with any intubation, and almost never with a UAC. Not that it's forbidden, exactly, but it's just Not Done. I'm very seriously considering asking mom if she wants to hold tonight. I weighed the baby last night as a sort of trial run for myself to see if I could safely get her on and off the bed, and it went fine.
My question is this: do any of you lovely folks who routinely allow holding with intubations and UACs have any tips for me? Other than, you know, "Make sure the UAC is well secured"? That's sort of a given, yeah?

You amaze me you look after these tiny little wafes.

I WOULD be a nervous wreck so I admire the work you do in the PICU.

Working ICU was hard enough with big people :bugeyes:

You are a very caring person and I am thankful you are thinking as you are.

If I was the Mum I would be bereft if I could not hold my child.

Do what your heart tells you to do.

I pray the Mum gets to hold her little girl :heartbeat

hikernurse · May 18, 2008

Good for you, Eliza. Mom will never forget your kindness. We have the same "non"-policy at work. Nothing official, but it isn't often done. It sounds like you have all the bases covered. Sometimes I think we work so hard doing "everything" for a baby that by the time we've reached the end of our ability to do so, it's too late for mom and dad to spend any quality time with their wee one. You're a good nurse :nurse: .

dawngloves, BSN, RN · May 18, 2008

Make sure there is a camera handy. They may never get this chance again.

Other than that I'll re iterate, tape the bejesus out of everything because you know they'll be heck to pay if the UA comes out or the baby is extubated.

bubbly · May 18, 2008

At my hospital, it is common to let parents hold intubated babies, but not ones with UACs. With UACs, you can at least tell parents that the most they usually stay in for is a week (or up to 10 days if Drs really push them for the real sick kiddos). For the intubated babies, we always have 2 nurses - one to hold the baby and one in charge of keeping the ET tube in place and able to reach. Then we will really tape the ventilator tubing securely on the chair to keep it from pulling. I've never seen a problem with that method in the short time i've been a nicu nurse. Good luck and I think it is great that you are so helpful to this mother in assisting her hold her baby for the first time. :nurse:

SusanKathleen, RN · May 18, 2008

You are my hero! Let us know how it goes.

Imafloat, BSN, RN · May 18, 2008

I have let moms hold intubated babies with umbilical lines before. You will just need some helpers. I am a little overkill, but I always get an RT to help with the vent and another nurse to help with the baby while I guard the lines, it just makes for a much smoother move. Bless you for being such a good nurse!

prmenrs, RN · May 18, 2008

I, too, am proud of you. It can be done. Definitely have a camera handy. Ask a sympathetic Resp Ther or another RN to stand by to help. Tape the tubing to mom, sometimes resp tubing works better if it's over her shoulder. She can hold monitor cables and IV tubing thru her fingers.

Watch the ETT closely - they have a tendency move around a bit more. I'd be more worried about that than the UAC, because those are usually taped better. Lips are more flexible.

Good luck--let us know how it goes!

preemieRNkate, RN · May 20, 2008

We have the same "rule" in my unit too. I have let parents hold with ETTs and umbilical lines before though. More intubated babies than those with lines, but I have taken a baby with both out before. I figure that the umbilical lines are sutured in, and we use a bridge to tape them in place. They're pretty well secured, the thing that makes me nervous is swaddling the baby (or having the baby belly-to-chest if kangarooing) and not being able to see the site. And as long as the ETT is well taped to the baby, and the vent tubing is well taped (to mom's shoulder is where I usually put it), everything should be fine.

Find yourself a helpful coworker or two, get mom comfy in a chair (so she won't have to squirm around and potentially dislodge something) and get the camera ready.

I realize that you posted this yesterday, and you may have already let mom hold the baby. Hopefully it went smoothly, please let us know!

Jolie, BSN · May 20, 2008

Holding babies with ETTs, UACs, radial art lines, etc. was standard procedure at the very first NICU where I worked, as long as baby could tolerate it. I was "raised" to think that was perfectly normal. It bugs the heck out of me when parents are told that they can't hold a baby for any reason other than poor tolerance.

Good for you!