Newborn nurses please help!

[sweetcheekers]

Our OB unit has recently begun giving the hep B vaccine to our newborns prior to discharge if the parents elect to have it. We recently discovered that we are not all administering it with the same size needle. What do you feel is appropriate for an IM injection in a newborn, both guage and length? The research I've done states 7/8 to 1 inch in length but all the nurses I work with are shocked at this, and it does seem kind of long, however some are giving it with a TB syringe which I think is way to short for IM. Any thoughts?

[ragingmomster, BSN, MSN, RN]

We had been using a TB syringe but have recently gotten new protocols based on CBC rec's. please check with them.

We are now using a 7/8 needle on a prefilled HepB syringe.

Hope that helps.

p.s. we give the Hep B at birth to watch for reactions until d/c. Vit K on one thigh, Hep B in the other.

[EricJRN, MSN, RN]

Moved to NICU/Neonatal Forum for more responses.

[Gompers, BSN, RN]

We have single-use vials, not ready-made syringes for our hep B vax. We draw them up with TB syringes and then switch to a new, sharp needle - 5/8 inches long, 27 gauge.

[TiffyRN, BSN, PhD]

Our unit uses 5/8 inch long needle but most of our kids are little (NICU). I've never thought about using a longer needle on the bigger kids, but maybe I should?

[TazziRN, RN]

When I inject neos in the ER I use a 5/8 inch needle.

[dawngloves, BSN, RN]

We use TB, but mind you I send home kids that weight 5-ish pounds.

[LoveTheNICU]

We just switched within the last year, and now use a 30g, 5/8in needle for all our IM injections. Prior to that we used a 25g needle of the same length. While I like the new needles for our micropreemies and such, I have had a few incidences (as well as other nurses) where the Vitamin K is so viscous we have trouble administering it through such a tiny needle. I was helping with an admission the other day where the syringe briefly popped off the end of the needle because the other nurse was having to press so hard on the plunger... Thank goodness I was holding on to the baby! Our practice council is looking into any possible changes...

[Justhere, BSN, RN]

We also give in the Nursery the Hep B in the right thigh 25 gauge 5/8 needle and then give the Vit K in the left thigh with TB syringe, this takes place as soon as they are brought to the nursery after birth.

[Jokerhill]

My paperwork says it should be given in the first 12 hours after birth, not at discharge.

[mitchsmom]

My paperwork says it should be given in the first 12 hours after birth, not at discharge.

You're talking hep B, not vit K, right?

Does your paperwork have the rationale? Just curious because we don't do that.

We use tb syringes for newborns (a regular birth unit, not a NICU).

[RNin2007]

We only give hep B within the first 12 hours if there is question of transmission from mom to baby, or high risk...I also believe Neofax says this.

I was taught to use a 25 gauge 5/8" needle...on the tinier neos.

~J