Oh how the (NICU) times have changed

babyNP., APRN · Nov 1, 2017

The field of neonatology traditionally starts with the preemies in incubators for public display at the turn of the century, but another beginning people point to is JFK's son who was born at 34 weeks gestation with classic RDS. They didn't have ventilators, let alone surfactant back then and the most they could do for him was put him in a hyperbaric chamber. There was discussion about taking him to Canada where they were experimenting with ventilators, but deemed to great a risk since he was the president's son. This spurred a lot of research being put into neonatology after he died.

The original neonatal ECMO trials were done in the UK. ECMO was only brought to the US because it wasn't approved ethically until it was proven in the UK to have a better outcome than standard treatment. Kind of hilarious...but it still happens today. We wait and see what Europe does and then copy them. Omegavan originated in Germany- although the tides are changing and going towards SMOF since the FDA will never approve omegavan (currently it's used under experiment/compassionate use)

vintage_RN, BSN, RN · Nov 2, 2017

My fave is some of the older nurses on my unit say that they used to only have one pulse oxymeter and would use it on the "sickest" baby, and then just rotate it around between the babies every so often to make sure they were all still good í ½í¸‚í ½í¸‚

KKEGS, MSN, RN · Nov 2, 2017

Or sticking an NG tube down, letting the milk or formula just run right in and then pulling the NG until the next feeding versus keeping the tubes in and using a pump and feeding them slowly.

chare · Nov 3, 2017

[...]
The original neonatal ECMO trials were done in the UK. ECMO was only brought to the US because it wasn't approved ethically until it was proven in the UK to have a better outcome than standard treatment. Kind of hilarious...but it still happens today...

I'm curious, which trial exactly are you referring to? And when was it conducted?

allnurses Guide · Nov 3, 2017

Yay, I'm not as old as I thought I was! I don't remember any of the practices in your post adventurern.

I didn't work with the most critical babies but lots of my patients were gavage by gravity, 5 or 10 mls with the tube placed only for each feeding.

There were no pulse oximeters on my DOU unit, (babies as young as 2 weeks), most had butterfly scalp vein IVs. The interns had to restart them. They got lots of practice. :-/

We had a lot of unusual diagnoses, so there was lots of traffic observing certain patients but I've always felt bad in retrospect, that a set of conjoined twins transferred to the unit literally had a line of people waiting to see them. I hope the parents weren't there, because it had a real circus atmosphere I regret taking part in. A great experience overall, though.

Best wishes to you!

meanmaryjean, DNP, RN · Nov 4, 2017

My first job as an RN in 1980 was in NICU. The outer limits of survivability was 28 weeks. Ultrasound was rarely used. ZERO prenatal cardiac diagnosis. But that was ok because there was no PGE and the 'treatment' for single ventricle physiology was to wrap baby in a blanket for parents to hold until it died.

We had transcutaneous oxygen monitors instead of pulse oximeters. They left little circular burns of you forgot to rotate sites. And there were no ongiocaths for little ones. Steel butterflies- you can imagine how much time we spent re-starting IVs.

babyNP., APRN · Nov 5, 2017

I'm curious, which trial exactly are you referring to? And when was it conducted?

I heard it in a lecture in grad school (and actually on my old unit as a nurse) so I don't know the exact trials, but I'll search around on PubMed and see if I can find it.

itsybitsy · Nov 8, 2017

We had transcutaneous oxygen monitors instead of pulse oximeters. They left little circular burns of you forgot to rotate sites.

Can't regular pulse oximeters now still leave burns from the light if you don't switch sites? Our educator still has the policy written as so. Wondering if we are stuck in the times...

itsybitsy · Nov 8, 2017

The only thing I can think of is when kids were on oxygen, many times, I have been told they would just blast the O2... Well, we all know how that probably turned out. :cool:

itsybitsy · Nov 8, 2017

OH! And force feeding galore. And when they start to eat solids they can't as much look at a spoon, let alone have anything come close to their faces. But that still happens everyday...