Intraventricular Hemorrhage Management Protocols

Mags4711, RN · Feb 10, 2006

Hit up the Vermont Oxford network. They track that information and work on developing best practices for prevention of IVH. We have a protocol and I will dig it up tonight at work. I'll try to get it posted tomorrow.

Ginarrnc · Feb 23, 2006

I am at a 72 bed (and growing) level III regional referral center in Dallas. WE have a Minimal Stimulation protocol for all infants

dawngloves, BSN, RN · Feb 23, 2006

Head u/s @ 72 hours for 72 hours and hemodynamically stable,MAP parameters when on dopamine...

These are things I can think of that would pertain to interventions that would affect the outcome of IVH, but not specifically for IVH.

LoveTheNICU · Feb 23, 2006

Where I am a nurse extern, we have a whole new protocol/ standing orders sheet for IVH prevention that was done from an evidence-based practice study. I can see it in my head but can't remember exactly all the specifics. I'll grab one my next shift and post it for you then... :nurse:

BittyBabyGrower, MSN, RN · Feb 24, 2006

Off the top of my head....we elevate the head of the bed, don't warm them up too quickly on admission (the vasodilation can lead to a bleed), keep their temp no higher than 36.5-36.8C, no direct heat to head (ie warm packs), hands on only every 8 hours if we can, low lights or a towel over the eyes, keep BP stable with strict guidelines on MAP (shouldn't go lower than what their gestational age is ie: a 22 weeker can have a map as low as 22), minimal suctioning (this raises the ICP and RDS is usually not a mucus producing etiology), watch electrolyes closely, avoid NAHCO3 when possible. The hardest thing is for the first few days is to keep visitors down to a minimal touching. We have also found that if we put them on eggcrate and nest them really well, they are very quiet. We will provide sedation as needed, but usually once they get comfy in their nest, they are very quiet.

SteveNNP, MSN, NP · Feb 26, 2006

Thanks for all the great info....if you wouldn't mind posting the protocols you've found, or pm me for my email address, and you can email them if you want. Thanks again!!

SteveRN21

MinehartNICU · Sep 22, 2010

Hey, I was wondering if any of you would be willing to send me information on the IVH prevention protocols used in your NICUs. I'm trying to put one together for our NICU, specifically for midline positioning/IVH prevention. I have a lot of literature but would love to see some actual protocols in place. Feel free to send me a personal message, I would really appreciate it!

BittyBabyGrower, MSN, RN · Sep 24, 2010

Ours aren't really a protocol, it is a standard of care that we have incorporated into our policy and procedures.

MinehartNICU · Sep 24, 2010

Oh, ok, well my project is just specifically on midline positioning as it relates to IVH. I have a ton of info. on it already but have yet to see a pre-existing standard of care or P&P for it. Does yours include this and if so, would you be willing to tell me a little more about it or send me a copy?

BittyBabyGrower, MSN, RN · Sep 24, 2010

It just states that the head should be midline with the body for at least the first 48 hours. We put it under positioning on our routine care protocol.