Quesrion for NICU nurses

  1. My baby with pulmonary hypertension was getting a routine procedure - intubation and PICC line placement. Something went wrong and she felt the poke of the needle and went into a PH crisis. They had to also go up on her sedation because of this. My question is, in your NICU when you have a baby with PH, do you have anesthesiologist present during intubation and PICC line procedure? I feel something went wrong.
  2. Visit parlanchina profile page

    About parlanchina

    Joined: Jul '18; Posts: 6

    12 Comments

  3. by   NICU Guy
    Our Attendings and Fellows do all our intubations and we have a PICC nurse that place all of our PICCS. What gives you the impression something went wrong.
  4. by   chare
    I agree with Guy in Babyland. While I work PICU, not NICU, we still see a fair number of babies with pulmonary hypertension. In our unit, either our attending or fellow will intubate all of our patients. The only time either anesthesia or ENT are called is for a difficult airway/intubation. As for PICC placement, one of our PICC nurses would try first, and if they were unsuccessful one of the NNPs would come from the NICU and place it for us.

    Please consider this; these babies can be some of the most tenuous patients we see. These babies require intensive care, and it often takes little to no stimulation to precipitate a crisis. A crisis can be precipitated with even the gentlest of routine care.

    If you have specific questions regarding the care your baby received, they should be directed to the team providing care as they are in the best position to advise you.

    Best wishes to you and your baby.
  5. by   Wuzzie
    Is this your child or a patient you are caring for?
  6. by   parlanchina
    They assured me she would be adequately sedated and not feel anything, yet she felt the PICC line needle and right after that, went into pulmonary hypertension crisis. With pulmonary hypertension cases, I read that special precautions are necessary. In other words, you can't use the same intubation protocol that you are using for ordinary cases.
  7. by   parlanchina
    My child.
  8. by   chare
    Quote from parlanchina
    They assured me she would be adequately sedated and not feel anything, yet she felt the PICC line needle and right after that, went into pulmonary hypertension crisis. With pulmonary hypertension cases, I read that special precautions are necessary. In other words, you can't use the same intubation protocol that you are using for ordinary cases.
    These are questions best directed to the team caring for your baby, as they are familiar with your baby's condition.

    Again, best wishes to you and your baby.
  9. by   parlanchina
    Thank you.
  10. by   Miiki
    Not only does the anesthesiologist not ever attend intubations in the NICU, but if it is anticipated to be a difficult airway before a surgery, they will have the neonatologist or neonatal nurse practictioner intubate in the room before bringing them to the OR. The NICU staff are going to be the best trained for procedures on babies.
  11. by   meanmaryjean
    Per the Terms of Service we cannot provide you with medical advice. Please discuss the situation with your child's care providers.
  12. by   Mavrick
    Quote from meanmaryjean
    Per the Terms of Service we cannot provide you with medical advice. Please discuss the situation with your child's care providers.
    This thread is just asking for trouble.
  13. by   parlanchina
    Yes, I will discuss this with them. My baby was supposed to have a surgery after the intubation. But because she felt the pain from both intubation and PICC needle she went into PH crisis so the surgery was postponed. The nurse practitioner told me she will take care of her. Hmm, I see that.. I feel no baby should feel pain in these routine procedures such as intubation and PICC line placement.
  14. by   tnbutterfly
    As others have said, these are questions you should ask your baby's care providers as we cannot provide medical advice. We wish your baby well.

    Closing this thread to further discussion.

close