Kangaroo Care

NICURN29 · Dec 4, 2008

We use kangaroo care, although not everyone is totally on-board with it in all cases. We try to use it even when kids are stable on the vent, and we are pretty good about doing it when kids are on CPAP or cannula, but some people's comfort levels make them hesitant to do that. We definitely do still have the moms that end up waiting a long time to hold their babies, but I think the tide is turning.

NeoNurseTX, RN · Dec 8, 2008

we do it but it sure makes me nervous with the vents.. especially when a mom tells me, oh, last two times i KC'ed, she extubated!

kangarooyou · Dec 8, 2008

we do it but it sure makes me nervous with the vents.. especially when a mom tells me, oh, last two times i KC'ed, she extubated!

I have luckily never lost a tube, or a line thank goodness...I just make sure that I have an RT to deal with the vent, another nurse for the lines and myself helping the mom. Mom stands up next to bed, bends over baby, picks up baby roll and all....and sits right down in KC chair next to bed...we usually un hook the monitors for a moment while we position...one less thing to move...mom sits down and then the re position starts...always vent tube first, taping to the skin not the gown, then back on monitor to make sure tolerated transfer well. You should have lots of help moving, securing etc.

RN4Little1s · Dec 8, 2008

I feel lucky. Everyone is on board with kangarooing on our unit! The nurses that have been there forever are all for it, and the best ones at maneuvering baby an parent into position. I really am nervous when they are on the vent, but most of the parents aren't so I try not to let my anxiety show through! I must say that transitioning always goes better with a nurse and an RT rather than 2 nurses. I think the RT just always does a smoother job with the tube.

I love the kangarooing chairs that allow the parents to lean back and stretch out. We also use mirrors so they can see their baby's face better. Dad's also kangaroo.

BittyBabyGrower, MSN, RN · Dec 10, 2008

We do it....the only kids that can't are the ones with UACs...the docs dug in on that one. We do vent kids all the time. But...if the kid tends to extubate, then the docs put the kabash on it We make sure to retape any tube that looks questionable and then tape the tubing well!

2curlygirls · Dec 10, 2008

One of our Neo's has informed us we need to become comfortable KC'ing on HFOV.

I'll do it with a vent but an oscillator???

Doing it with deep lines and vents makes me a bit nervous. I'll do it, but I want help!

hikernurse · Dec 10, 2008

We don't do KC with umbilical lines, high flow or oscillator and it's up to the nurse's comfort level if the patient is vented. Our RTs are great about getting vented babies out of bed. We're really pushing to encourage moms/dads to do this. Some are a bit squeamish about the whole skin thing, but most can't wait.

I'm jealous of the kangaroo chairs, we just use rockers. Hah, I'd probably use the kangaroo chairs once parents were gone. Nurses need to stretch out too, LOL.

But, Neonurse, if a mom told me her baby had extubated the last two times, I'd make sure my RT had time to babysit before I even began to get the kiddo out :).

MegNeoNurse · Dec 10, 2008

We do kangaroo care in our unit, the parents LOVE it. I always bring it up to the parents and tell them it's always an option.

We do not let parents hold babies

We have a minimun KC time of 30 minutes, because alot of the time some of the smaller babe's take some recovery after the transfer. I'm comfortable with UACs and UVCs, my first KC experience was when I was on orientation and the babe had a UAC, my preceptor told me I might as well get comfortable with it. Obviously I was in close proximity to the baby and checking in every few minutes. Luckily, never lost a line or tube **knock on wood**.

Good luck with getting KC going in your unit, it's so great of you to advocate for your little patients and their families!! :yeah:

Preemienurse23 · Dec 10, 2008

hikernurse, your unit does not kangaroo with a high flow nasal cannula? Or are you referring to something else?

I encourage kangaroo care with all my parents. Esp my younger ones when they are stable. I'm not fond of KC when they are vented, extubations are too high. That seems to be the general opinion on the unit too. The few nurses who do KC with the vents tend to extubate.... I would never think about KC on a HFOV or Jet, these kids are usually too small/unstable, plus the tubing for a HFOV doesnt allow for much movement in the bed.

NICURN29 · Dec 10, 2008

I forgot to mention that we do not allow for KC with a UAC in place...or when a baby is on HFOV or the Jet. We have had a mom hold a baby who was on the Jet because it had been a while, and she had not been able to do that yet, but he was weaned from the isolette by that time, so she didn't kangaroo...she just held.

hikernurse · Dec 10, 2008

hikernurse, your unit does not kangaroo with a high flow nasal cannula? Or are you referring to something else?
I encourage kangaroo care with all my parents. Esp my younger ones when they are stable. I'm not fond of KC when they are vented, extubations are too high. That seems to be the general opinion on the unit too. The few nurses who do KC with the vents tend to extubate.... I would never think about KC on a HFOV or Jet, these kids are usually too small/unstable, plus the tubing for a HFOV doesnt allow for much movement in the bed.

CPAP is what I meant to write--obviously I was way too tired to be thinking, much less writing anything down... :rolleyes: . High flow, no big. Sorry .

I'm not a big fan of vented kids on KC, but some of the more experienced nurses have no problems with it. I've had a couple of "un-ordered" extubations (fortunately on kiddos who did fine with watchful waiting, no re-intubation) and I don't really care to have a more unstable baby extubate. We do let parents hold vented kids, but it's easier when everyone has their shirt on and isn't behind a curtain :).