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Discussion

Priority action for GASTOSCHISIS

would it be to cover with sterile- salined dressing?

or

IV fluids?

Featured Replies

  • Author

would the priority for this condition in newborns be to

cover the exposed bowels with sterile-saline dressing?

or to

administer IV fluids?

Your first priority is to cover the defect with a sterile moist dressing or sterile turkey bag (no, I'm not kidding) to protect from fluid loss, exposure to pathogens, and injury. Starting an IV would be a close second.

I would cover first then IV second.

  • Expert

Cover first because infection is what kills these kids. Then, place an umbilical artery catheter (either the APN or MD does this) and start fluids.

I would cover first then IV second.

That was my first thought

  • Expert

They have sterilized plastic bags that you put on the bottom 1/2 of the baby to above the level of the defect; it may have a string you snug up. That is better than saline dressings.

The baby will go to surgery right from the delivery room, unless they need to transported 1st.

Baby may need to be intubated, this is better than bag and mask ventilation which will probably introduce air -> the gut.

As everyone has mentioned the turkey bag first. At our hospital the baby will be "reduced" each day by surgery. IV is an important second. PLEASE advocate for your pt. by having the MD, NNP write for a Duramorph (morphine drip) and perhaps morphine boluses when the baby is being reduced (intestines pushed in).

You absolutely need to cover to deter infection and more immediately, heat loss!

  • Author

thank you for the clarification all!

  • Author

ty for the clarification all!

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