Interesting cases anyone?

Specialties NICU

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I work in a medium size nonsurgical level III NICU so sometimes things get a little boring. Sure, on occasion we get a really interesting case, but for the most part it is preemie land. So does anyone have any interesting cases from NICU, PICU, or CICU? I know with all the privacy laws you can't give too many details. I recently heard of a case where a newborn contracted Legionnaires disease from a home water birth.

I really enjoyed when Janfrn would do her "case studies" as a topic. Hint, Hint ;)

Specializes in NICU Transport/NICU.
New to NICU here, SO for some of you this may not be too interesting. However saw a full gestation c-section, severe IUGR, 3 missing limbs, trisomy 18, anomaly of the airway, trachea had to be inserted while still attached to placenta, straight to oscillator, then Ecmo the following day. It was interesting learning experience from afar but sad at the same time. I feel honored to have had the experience to see the birth. Maybe as I become more seasoned I will have the opportunity to take those type of cases. Although, that was a rarity on my unit I hear.

I think you'll be hard pressed to find any NICU nurse who doesn't find that pt interesting.

Specializes in NICU.
New to NICU here, SO for some of you this may not be too interesting. However saw a full gestation c-section, severe IUGR, 3 missing limbs, trisomy 18, anomaly of the airway, trachea had to be inserted while still attached to placenta, straight to oscillator, then Ecmo the following day. It was interesting learning experience from afar but sad at the same time. I feel honored to have had the experience to see the birth. Maybe as I become more seasoned I will have the opportunity to take those type of cases. Although, that was a rarity on my unit I hear.

That's a lot of intervention for a Trisomy 18 baby with multiple anomalies. Did they know ot was Trisomy 18 at the time of birth?

Specializes in NICU, PICU, PACU.

We had one kid we had to tube like that...he had a massive internal hemangioma in his neck and pretty much didn't have an airway. Could only get a 2.5 in this term kid. He got a trach within 4 hours. We ended up sending him across town for surgery.

anesth. came up to help us tube a bad baby...4.5+K kid and they pull our 4.0 that "slipped" in and stick in.........a 2.5! :banghead: lesson learned, don't call anesth. for help, we were doing just dandy on our own lol

The level IV team (we only have level 2)came for transpo for hypothermia and were so confused, so were we!

In anesth. defense, they usually only tube pyloric stenosis kids, who are average 6wks old so of course this gargantuan child looked small to them!

That's a lot of intervention for a Trisomy 18 baby with multiple anomalies. Did they know ot was Trisomy 18 at the time of birth?

Hi,

I am not really sure as I was never assigned to the baby. However, the parents were adamant about wanting everything done. Unfortunately, in less than a week neonate didn't make it .

Specializes in NICU, PICU, PCVICU and peds oncology.

Trisomy 18 kids are a challenge, no doubt about it. I remember one from years ago whose family wanted everything possible done, and went so far as to have the baby delivered in another city because their hometown OB-gyns weren't willing to resus if the baby was born flat. The kid's VSD was big enough to cause early CHF and post-repair we couldn't extubate for a long time. It was nigh on impossible to fit a BiPAP mask to that tiny face and the mom was very particular about how the hi-flow cannulae were taped, sometimes an hour's worth of tweaking and more tweaking was needed before she was happy. Only certain RTs were allowed to suction. Eventually they left our unit and about 18 months later we learned that the baby had passed away in another city, in a manner that was not what the family had wanted. Tough case.

Specializes in Nurse Scientist-Research.

Just found this FB page (which I'm pretty sure is public) about a child that is supposedly full T13 who appears way more functional than I would ever expect;

The in'Dee'structable Delainey: Living with Trisomy13 is on Facebook

I've heard of some T18 kids and some with mosaicism before.

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Specializes in CDI Supervisor; Formerly NICU.

Has anyone seen a baby with Harlequin color change? I saw one the other day, and it was amazing. Reminded me of the old Star Trek episode with the aliens that were black on one side and white on the other.

Specializes in Nurse Scientist-Research.

I've seen it a couple of times. In our large unit everyone's good about putting out an alert so everyone has a chance to see it.

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Specializes in NICU, PICU, PACU.

I've seen several over the years, pretty impressive! It is wild how there is a clear line of delineation!

Specializes in NICU.
Has anyone seen a baby with Harlequin color change? I saw one the other day, and it was amazing. Reminded me of the old Star Trek episode with the aliens that were black on one side and white on the other.

It's kinda neat huh? Whenever we see one we pull over any students or newbies to see it.

As a side note, that's how I saw my first harlequin ichthyosis baby. Someone said have you seen the Harlequin baby in bed X? I'm like "oh sure I've seen that before." She's like "really? That bad?" Confused, I went to see the baby and oh...my...God...

Specializes in Nurse Scientist-Research.

Harlequin sign (not the ichythosis!) is generally a harmless phenomenon in a newborn. It is however abnormal in older kids. A fellow nurse I used to work with saw it in her 2yo and knew what it was. Investigations led to the discovery of a neuroblastoma which he is still fighting.

Micah | Photos | CaringBridge

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