Positioning for HFOV

[menemsha]

Interested if you are doing regular re positioning on these infants, say turning from side to side.

For example month old corrected 28 weeker 900gms.

H/O Klebsiella pneumonia.

On HFOV for a week with right upper lobe collapse.

Do you nurse supine with head mid line or 3hours with right side up & 1hour any other position.

What about chest physio.

Thanks

[Bortaz, MSN, RN]

We don't use the HFOV (we use HFJV instead), but our Jet babies are turned fairly frequently. I did 4 hours midline, 4 hours RSU, 4 hours LSU last night with my 23 weeker on the Jet.

[Bortaz, MSN, RN]

Accidental double post. :)

[dixRN]

Ditto to Bortaz on HFOV positioning. Repositioned every 4 hours and no chest physiotherapy.

[NicuGal, MSN, RN]

Ours is the same, less frequently if they are unstable. The shouldn't need CPT when on HF vents.

[umcRN, BSN, RN]

No real repositioning here. We "flip" every 12 hours either head to toe or back to front, the HFOV is always on the same side of the bed so we try to flip in a way that turns the kiddos head but they are typically either supine or prone unless a special circumstance

[AnonRNC]

We flip every 12 hours so they are lying on the other side of their head. Within that 12-hours we may (leaving the head in place) rotate the body to prone or supine (i.e. prone with head to right then supine with head to left - either way they are lying on the left ear). I do not usually have success getting a "good shake" when the patient is sidelying-although I like like it for facilitated tucking. In cases of extreme unilateral lung disease, the physician may order us not to reposition for the first 24 hours of HFOV.

No CPT w/HFOV.

[MegNeoNurse]

As long as baby is >28 weeks and a week old, midline positioning is not detrimental for prevention of IVH. If a pt is on HFOV the ETT is ideally a bit higher than normal (still below clavicles!) to decrease risk of right main stemming and associated risks. I wll position my pt on HFOV any which way... Supine, right or left side lying, prone. If your pt has RUL atelectais I would rotate between supine and left side down to promote reinflation of RUL. Hope this helps!