Suctioning after birth

cc_nurse · Jun 13, 2009

If there is meconium, there is not to be any suctioning done on the perineum. NICU is usually there to use a delee suction to clean out the muck before it gets below the cords.

NiesyLuv0o · Jun 13, 2009

If there is meconium, there is not to be any suctioning done on the perineum. NICU is usually there to use a delee suction to clean out the muck before it gets below the cords.

I am confused with your response...I was refering to suctioning the newborn. Is that what you are talking about?

PICNICRN, BSN, RN · Jun 13, 2009

When there is mec present, the baby is usually suctioned before the shoulders are delivered by the OB then handed to the NICU team- the baby is not stimulated so as not to encourage it to take a big old gasp of mec- then they baby is placed on the warmer, the cords are visualized and the baby is suctioned WELL at that time with a mec aspirator(usually) or a large suction cath(10fr). Sometimes they will do more than one pass. THEN the baby is stimuated/dried and the nose is suctioned out. There should not be any suctioning before the cords are visualized.

NiesyLuv0o · Jun 13, 2009

Thanks PICNICRN. Therefore the nose is suctioned first. When you say the cords...what do you mean? The cord attached to the placenta (meaning the first suction) or the cord when the baby (cord is cut) is under the warmer (subsequent suctions)?

Thank you

GOMER42 · Jun 13, 2009

vocal cords

NiesyLuv0o · Jun 13, 2009

:yeah:haha...gotchya...the vocal cords to intubate and do a deep suctioning I suppose. Sorry, I did not understand...i only have 6 weeks of OB and this is my final week and an exam.

Thanks a lot!

Coffee Nurse, BSN, RN · Jun 13, 2009

According to NRP protocol, if there is mec staining and the baby is not vigorous, intubation and endotracheal suctioning is indicated. However, if the mec is thin and the baby has good muscle tone, respiratory effort, and color, you can proceed with the normal initial steps following the delivery of a potentially compromised newborn (drying, warming, suctioning mouth then nose, and stimulating to breathe).

Coffee Nurse, BSN, RN · Jun 13, 2009

Er, in other words, basically everything that PicnicRN said...

epiphany · Jun 13, 2009

Exams will probably require you to say "suction at perineum", but you may not see that, because latest research shows it no longer changes outcome, and the trend is slowly changing.

CEG · Jun 13, 2009

Er, in other words, basically everything that PicnicRN said...

Not really. Current NRP guidelines do not recommend suction on the perineum. Suction should be performed only if the infant is not vigorous, and not on the perineum because you cannot tell if it is vigorous before it is born. You should review NRP guidelines to get a clearer picture of what to do- there are very easy to read and clear algorithms.

Many providers are slow to change their practice but that doesn't make what they do correct. If you are in nursing school then you should be getting the most current information (but in any case the "new" guidelines are now several years old).

NiesyLuv0o · Jun 13, 2009

If you are in nursing school then you should be getting the most current information (but in any case the "new" guidelines are now several years old).

Thanks CEG. I definitely want the correct information, so when I go to clinicals, I do not make a mistake. Also, my textbook must be old, because it said to suction the newborn as soon as the head comes out with the shoulders still in.

But does this apply only to the mec stained newborns or just about any newborn?

I know the right info now, but for my exam purposes, it will be the info in my book.