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?

[BittyBabyGrower, MSN, RN]

We don't use TB needles anymore...they aren't long enough on the fat kiddos. We use the 27gauge 5/8ths.

Hep B doesn't have to be given at birth...we wait until d/c to do it unless the kid is a long termer, then we wait until they are a certain weight. Hep B has 12 hours for unknown moms or high risks.

[Jokerhill]

You are right I am just so use to working in a high risk enviroment I think they all are. So 12 hrs is for unknown status and known Hep B at risk Kiddos. You can check the CDC's web site for the latest info.

[rn/writer, RN]

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

Hep B is given in the first twelve hours if mom's hep B status is unknown. HbIg (hepatitis B immunoglobulin) is given if mom is positive for Hep B. If mom tests negative, the hep b series can be started at any time, although it is recommended that the series begin within the first two months of life.