Developmental Positioning, Aids, and stuff like that...

Specialties NICU

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Hey, where do you guys get all of your developmental positioning stuff? I don't mean blanket rolls, I'm looking for specifically developed items used in positioning, bundling, etc. I found one site, Children's Medical Ventures, but they only offer one or two items. On a slightly different jag, how do you physically support your babies when they are lying prone? When side-lying or supine, we comfort with tightly rolled blankets, sometimes taped together to create a sort of 'womb', but I'm a bit confused about how best to support them when they are prone. We frequently have babies who are prone and will end up at the bottom of the isolette, despite our attempts at a sling to keep them in place. They seem to love the blanket rolls when they are on their backs (we roll them really big so their knees are supported, as if they were sitting in a chair, and it helps keep their hips straight, too). Oh, one more thing- if anyone knows of suppliers of neonatal items for the nursery, including linens, admit items, developmental care, pain control, etc., would you mind posting them here? I'm looking for ideas. Thanks!

We use the Snuggleups from childrens medical ventures all the time. We usually have a shortage of them. We also have what we call "snakes" they are bean bag rolls similar to the bendy bumbers. Our threads of love ladies make them for us, as well as clothes for the kids with IVs. Just about every baby has one or both. When we are out of both, we have to rely on blankets.

I stronlgy recommend the snuggleups. I have put my very "wild" and irritable kids in there and they calm down. I love them.

Specializes in NICU, adult med-tele.

We make our own swaddling cloths--22"square calico, hemmed. Some babies get too hot if you swaddle them in hospital blankets. You can position them prone and swaddled and in a nest.

That is a great idea!

Want to eliminate trying to be crafty with blankets, the bendy, etc? We use the Z-flo positioner, made of a fluidized material that does not have memory. It eliminates pressure point areas while providing maximum positioning abilities. Here is the website: http://www.sundancesolutions.com/neonatal.php

You can position, nest, comfort, and contain babies with these tools. We have mattresses and long tubes. They last about 3 months as far as being good and moldable. Positioning prone is especially nice because you can create a "prone roll" by molding one and placing the baby on it, then squishing up the material so that the legs may be placed appropriately. You don't have frog legs, and there are straps to use for containment.

To position - place the baby how you want them and then put one hand on the baby while using the other to mold to the baby. We took a class on them from a rep using dolls.

Other than this, we have had the bendy, the snuggly, and we use snoedels too.

We started using the z-flow about a year ago. They are great for the micros and the ones on cpap. They don't fit the bigger kids (30wks+) very well though. And they eventually lose the ability to stay in the position they are put in. But new I like them.

Specializes in Neonatal ICU (Cardiothoracic).
We started using the z-flow about a year ago. They are great for the micros and the ones on cpap. They don't fit the bigger kids (30wks+) very well though. And they eventually lose the ability to stay in the position they are put in. But new I like them.

We have both sizes, for preemies and termers...... I actually don't prefer them for the micros, as they end up looking like they are sitting on a table. I can do much better positioning with blankets.

Specializes in NICU.

The big ones are great for the really, really sick kids. Especially the ones with wandering atelectasis, who the MDs want you to turn a different side up after every CXR. Much easier just to squish and squosh the Zflo around than muck around with blanket rolls. And if you have multiple chest tubes (ahem) you can make little divots so you can kind of put the kids on their side a little.

Glad to see others are trying Z-Flo; I've worked in the NICU for many years, and Z-Flo definitely works best for positioning our babies. It takes some practice to get it right, but is well worth the effort to finally see fragile babies well positioned, comfortable, quiet, and sleeping! We use single positioners for very sick babies with multiple lines and tubes; the Z-Flo tube and smaller pad work well to contain active or agitated infants. I heard an educational video is now available from the company that shows how to use Z-Flo with NICU babies; has anyone seen it? Am hoping it might improve consistency among us, always an issue with anything new.

Specializes in NICU.

Can you X-ray through them?

Can you X-ray through them?

We've done a few x-rays on Z-Flo if just for line placement, but not where air accumulation can make a difference (lung fields, KUB, etc). And even x-rays for line placement are usually examined for whatever is visible, so x-ray through Z-Flo is not our normal practice. Really sick babies are usually on a cloth (thinner than a hospital blanket) on top of the positioner, so we just barely lift the baby up and slide the x-ray plate underneath the baby and on top of Z-Flo. For nurses who think x-rays with Z-Flo are too stressful for the baby, that's not our experience. Physical disruption is minimal, start-to-finish only takes a few minutes, and babies rest so much better when well positioned on Z-Flo for all the remaining hours and minutes of the day. All our critical babies (micropreemies, PPHN, surgical, etc) are on Z-Flo. Except haven't used with ECMO, which we don't do much anymore.

We are not allowed to xray through the z-flo for anything. We do as PP said and make sure there is a "draw sheet" like a pillow case, to go under. We only place the head piece under ECMO kids. Also, the other flaw is babies get very ot with the plastic material it is covered with. They come with a thin cover that says z-flo all over it, but the rep said 3 layers of something (be it blankets, burp cloths) over the z-flo makes the "hot factor" go away.

We are not allowed to xray through the z-flo for anything. We do as PP said and make sure there is a "draw sheet" like a pillow case, to go under. We only place the head piece under ECMO kids. Also, the other flaw is babies get very ot with the plastic material it is covered with. They come with a thin cover that says z-flo all over it, but the rep said 3 layers of something (be it blankets, burp cloths) over the z-flo makes the "hot factor" go away.

Temp control is one reason we need positioning consistency in our unit. A baby well contained in Z-Flo should be warmer because both surrounding air currents and infant heat loss are reduced. So turning down incubator heat output is an option, like we do if a baby is swaddled in the isolette. But if the next nurse has the baby less nested and more exposed, he might get cold and the heat is cranked up even higher than before. This problem is our technique more than Z-Flo. That said, we have had some babies get hot - - usually the incubator is still set too high (a hot topic here, no pun intended), but we will loosen the boundaries a bit. We're also thinking of experimenting with something different for the cover. If you use 3 layers of cloth, can you still mold Z-Flo enough to contour to the baby? On the plus side of keeping babies warm, we haven't used a K-pad (our "old" standard of practice) for any admission, even 23 weekers, since using Z-Flo.

Some of our Z-flows have to "z-flow" cover. But we usually put a pillowcase on top of it to keep it clean because it has the straps. If they dont have the cover, we usually put a blanket or pillowcase over it. Some put the z-flow IN a pillowcase, but it decreases how much you can mold the pad.

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