Jes RN

interesting! i'll have to do some investigating, i've been told the product we use is water based, though it is called aquaphor. thanks for pointing that out to me. doh! :uhoh21:

Aquaphor is a water based prodcut.

We used IV Retrograde (IVR) med administration when I first started in my unit. Not that it was too long ago, but I forget all the intricacies of the process. It allows for med administration without giving additional fluid, as you would by piggybacking. It's a loooong coiled tubing with two ports that is connected to your maintenance fluid tubing, one port close to baby and one closer to the pump. Basically, it allows you to draw off some maintenance fluid and push your IV meds into the coil (this way, the med is kinda sandwiched in between two pockets of maintenance fluid and floated in at the desired rate) the drawn up IV fluid got tossed, thus no "additional" fluid was administered with the med. Again, I don't remember exactly how, but there was a way to calculate how much fluid to float your med in with, so that it could be given in a certain time frame. Phew! that is IVR in a big, convoluted nutshell. :typing The problem with IVR is that all the drawing-off and pushing-in of fluid requires many entries into the line. There is large ongoing initiative decrease our central-line-related blood stream infections in our unit. So, we stopped IVR and moved to a closed med administration system. This, coupled with other changes in practice has helped us cut way down on our central line infections.

In our unit, we use a neolink adapter. The adapter has two ports; one for the suction catheter and one to attach a saline pillow for lavage (if needed). It stays affixed to the end of the ET tube and allows for "one man suctioning" while maintaining a closed system. Personally, I have never used the ballard inline catheter, so I can't speak to preference; however, we trialed them on our unit a few years back and not many liked them. Most found them bulky and like someone else had mentioned, they had a tendency to pull on the itty bitties' ETTs. Also, our CNS/Neos prefer the neolink because of less deadspace added to the tubing setup. Here is a picture of the adapter: http://www.corpakmedsystems.com/products/airway/neolink.htm I know this is an older thread, but I just thought I'd post, as we're using something a lil' different than the current posters.

On our unit, all infants

How exciting for you! First off, I'd like to say congratulations. All of those feelings were quite familiar to me before my first day too. Actually, they were ever present for quite some time! As newbies, everyone has them and if they don't, they should! :chuckle I've been doing this around a year and I still get nervous at times. As far as coping, I'd have to say, remember to breathe! Try and absorb as much as possible; no one expects you to know much at this juncture, so don't feel like you have to! Keep an open mind when it comes to learning experiences and know that you're jumping into the best jobs out there (in my humble opinion, ). As the days and months fly by you'll find yourself adjusting to your new role as a NICU RN. SO (phew), best of luck to you on your first day!! I hope it's awesome!

1) Do you have your parents scrub up and gown before coming in and visting their baby/babies? We have all parents/siblings/visitors do a 1-3 minute scrub with soap before entering the unit. We don't require them to gown. 2) Can you wear your wedding rings? Can your parents? We are allowed to wear bands, however, no rings with stones or any wrist jewelry. 3) What do you do when a baby has MRSA? Do you have to gown? Do your parents or visitors? When a baby has MRSA they are usually placed as a one to one assignment. We are required to gown and glove before any touching (infection control just changed that policy, we were required to wear masks as well). Parents and visitors are also required to gown and glove. 4) Can you wear your own scrubs, or are you provided scrubs by your institution? We're allowed to wear our own scrubs. Hope that's helpful! In answer to the addendum: I work in a 35 bed Level III NICU. We are a university hospital.

Do you know of any articles/links about using CPAP/NO on all preemies?

Oooh. We do Nasal SIMV, which is NCPAP with a PIP, PEEP, and backup rate. That sounds pretty similar if not identical to SiPAP. Different vernacular perhaps? I deplore those nasal SIMV machines as they have a horribly shrill apnea/low flow detected alarm. Thanks a bunch! :)

What is SiPAP? We use bubble NCPAP in our unit, but I haven't heard of SiPAP before. please share! :) Also, how do the Vapotherm units differ from the high humidity cannulas?

Actually, at the concentrations used for PPHN (16-25 parts per million) Inhaeld NO acts as a potent vasodilator, rather than a bronchodilator. I've also heard some units refer to themselves as level IV, though I'm not quite sure how they differ from level III. I work in a level III unit as well. We do INO, but not ECMO. I wonder if offering ECMO is a level IV qualifier?