oldest babies in the NICU?

[bubbly]

I was curious how long different NICUs kept chronic babies who did not meet requirements for lower level care facilities. Do you transfer these babies to a special pediatric floor in your hospital or do they continue to stay in the NICU until they meet lower level care discharge requirements. I am asking this because our NICU unit has and has had babies in our care for over 12 months, the oldest I think was almost 2 years before discharge. Just wanted to ask your thoughts, esp since by that age they should be treated like pedi and not neonatal.

[elizabells, BSN, RN]

The oldest we've had since I've been there was around 10mo. I hear tell that long ago they had one until she was almost 3. We're lucky enough to have a few peds LTC facilities nearby that have vent floors and such. I guess if a kid was really still critical they might go to the PICU, but I haven't seen it happen. We do send kids to the floor sometimes. Problem is that even if the parents sign something on admission that agrees to transfer the kid when they're stable (especially if they txfr in from an OSH) when the time comes they can still refuse. We've had that happen.

[EricJRN, MSN, RN]

We don't have a peds floor or a PICU at our hospital, but we generally ship kids out to a pediatric LTAC by 6-7 months.

I have heard stories of the old days, when apparently there was a patient who was old enough to push her own IV pole and munch on Vienna sausages.

[Andie13RN]

We have a 14 mo boy and a 16 mo girl but it´s basically because we don´t have any beds available in PICU.

[preemieRNkate, RN]

I think the oldest we've had was just shy of her 1st bday. That was about 5 years ago, before I worked there. The last old baby that we had was 7 months old before we could send him to LTC.

[justme1972]

The facility where my children were kept babies from birth until discharge...for however long that took...even if it took a year, if the needs were met.

Once they went home, they were considered "contaminated" (I think you know what I mean by this), so once they went home, if they had to come back to the hospital, they went to PICU.

The only exception was a home birth or a baby-in-a-dumpster-type thing.

[elizabells, BSN, RN]

We'll take discharges back if they come in with a NICU-type problem - the early discharge 34 weeker who suddenly has a blown-up belly, or won't eat and gets jaundiced. They do come in on contact isolation, though, until their cultures clear. Most other problems will go to PICU or occasionally the floor.

[Sweeper933]

We will also take back our own "grads" if they get sick shortly after going home. They have to go into isolation until they go home. Our hospital has a peds floor, but not a PICU - so we will also take those term kids who get sick a few days after going home as well.

As far as our chronics are concerned - the oldest I've seen on our unit is 8mo old - she was then sent to a long-term-care facility. Between her family situation, and her not so good medical prognosis, that was pretty much the only thing we could do for her. In the "old days", our unit would routinely have chronics that were over a year old before they could go home. Thankfully stuff like surfactant has "cured" a lot of that...

[Imafloat, BSN, RN]

We have a couple of 7 months old right now. I work at a pediatric hospital. Our graduates usually go the intermedate care unit, which is kind of like an ICU for chronics. I have heard the stories of babies who had their first birthday parties on our unit.

[Sweden]

We recently had a 18 month toddler (born after 24 weeks, still ventilator dependant) but I do think we hold the record for the oldest "child" because we had a boy here for 20 years. He was home during the day,went to regular school but since he had a syndrome that made him ventilatordependant when he slept he came to the unit to sleep.

[dawngloves, BSN, RN]

We had a former 24 weeker for almost 12 months. It really is sad because we have no Child Development specialist and our PT/OT person is in once a week. Our local LTC facilty will only take them if they are vent dependant or need a g tube, so we hang onto them for months. And that is one reason why preemies are so developmentally delayed.

[dawngloves, BSN, RN]

We recently had a 18 month toddler (born after 24 weeks, still ventilator dependant) but I do think we hold the record for the oldest "child" because we had a boy here for 20 years. He was home during the day,went to regular school but since he had a syndrome that made him ventilatordependant when he slept he came to the unit to sleep.

Why couldn't he be on the vent at home?