How to deal with RSV

Gompers, BSN, RN · Mar 1, 2007

We very very rarely allow a baby to be readmitted to the NICU after discharge. They usually go to the pediatric floor or the pediatric ICU. It sometimes depends on what the baby is coming back for, but the general rule of thumb is that the baby is no longer "clean" and thus shouldn't be back in the NICU with all the preemies. Now, if a baby is coming back specifically for a respiratory infection during RSV season, then DEFINITELY they are not allowed back in the NICU. Instead they go to pediatrics and are isolated there. It's much easier to do isolation there because there are separate rooms in peds, many with reverse ventilation systems for respiratory isolation. Our unit is a big open one, so you cannot do respiratory isolation, only contact.

SteveNNP, MSN, NP · Mar 1, 2007

Infants cannot be admitted to NICU after leaving the hospital. They are admitted to general peds/PICU after readmission, even if the family turns around at the door and returns. All at-risk infants are not discharged until they have received Synagis and a followup appt at our peds clinic. We haven't seen a huge RSV epidemic this year.... more ATV traumas than anything else ( I work PRN in PICU... note to parents.... keep your kids away from ATVs... they are the #1 cause of traumatic injuries admitted to our PICU, even more than car accidents....)

Jokerhill · Mar 5, 2007

We don't re'admit kids but we have had RSV in our unit. What we did was test every kid the isolate all the positives from the negatives. And keep all new babies in another room. his creates 3 different sections. The staff is kept with the kids they have had. So you have clean, dirty, and exposed staff. What a messy way to do it but we don't have a picu or any place else to send them. All the supplies are then brought to each area and kept apart as well. We have lost kids in the past to RSV and don't want another baby to die, so we take it very serious. All the kids are kept separated like this until discharge. You will never prevent 100%, but good parent teaching, keep anyone with any signs or symptoms out yes nurses get colds too, (no it is not allergies or dust that is the next season). Yes, it is tough to be short of staff and yes, they want to work but #1 we have got to protect our kids, they can not protect themselves. In doing this you can't have management harassing staff for calling in sick (They just refuse to understand don't they) in some jobs you can work when you have a cold but thats not true in our job. Watch, watch, watch for signs and symptoms in the Babies then isolate as soon as you even think you may have a bug in the unit. I have never seen a neonate that was not immunocompromised we have to do our very best all the time.