do you guaiac routinely?

[nell]

Back in the "olden days" we used to check specific gravity and dip urine; and guaiac stools as well as check for reducing substances on a routine basis on all preemies.

Does anyone still do any of this? If not, does anyone know why? Was it not worth ithe time and expense?

Guaiac testing was taken away from us about four years ago. We now send a spec. to lab (and wait forever for it to be done...) only when we have other suspicious findings, and with an order(usually standing order). I have heard different stories on why we can't do it ourselves: billing issues, JCAHO, slides would expire, etc.

We have had several kids with frank blood in their diapers (one was noted in the last diaper change at discharge - stayed one month longer than her twin) and I wonder if routinely checking stools for occult blood could prevent these full-blown NEC cases.

I recently found out that not only can they guaiac stools on the adult floors, but the CNAs do it, not the licensed staff.

So I'm wondering: is there a good reason why we don't? Did I miss a study a few years ago where it was proven to be worthless????

Thanks for any advice.

[dawngloves, BSN, RN]

Cost????

We heme test all stools on all kids. Heaven forbid......

And we dip a urine q shift.

[Heather333]

All kids under 37 weeks get heme tested. If on IV's or HAL then specific gravity & glucose on urine Q6 and once off fluids Qshift.

Heather

[NICU_Nurse, BSN, RN]

We recently had this ability taken away for cost reasons. Now, if a guaiac is needed, we have to have a written order and we have to send the sample to the lab. I think it's ridiculous, honestly, but what to do? ;>)

[NicuGal, MSN, RN]

We can't do them anymore either. We rarely send guiacs on kids...we were getting to many positives from high fissures and the residents would freak out and make the kid NPO and on NEC precautions.

If a kid's belly blows up or if it is puking alot, we will ask for an order for Guiac and Reducing Substance.

We rarely ever do SG anymore....they never did anything with the results.

Glucose...NPO, once a day. With HAL changes 4 hours after it is hung and then at 8 hours. If septic, once a shift, sometimes Q4.

[Brownbetty]

we heme check all stools with hemeoccult.

[KRVRN, BSN, RN]

We heme test stools once a shift or more often if we are suspicious (assuming the kid stools more than once). We don't generally freak out over a positive stool unless there's other reasons to. Just puts us on guard a little more as far as asessing the abdomen, etc. Once in awhile I will suction a baby's nose and get a little blood. Then towards the end of the shift the kid will give me a heme positive stool. Hmmm wonder why?

We also do specific gravity and urine glucoses once a shift for all kids on IVF's and diuretics. We don't generally do anything with it unless there's glucose dumping in the urine... then we follow up with a bedside glucose.

And I'm embarrassed to ask... what is reducing substance?