CLRN

What a beautifully written article! Way to learn from a mistake, correct it and use it to help others! I work at a children's hospital where 90% of our patients have a lifelong condition/disorder (mostly CP, spina bifida, seizure disorders). I will be printing this article out and sharing it with my coworkers. Thank you for sharing it.

I know this is an older question but if you just need a small amount of urine another trick is to use the urine collection bag (follow the technique JanRN described) but put a couple of sterile 2x2s in the bag. That way when the child voids you can ensure that you get urine. Then take the soaked 2x2s, put them in a sterile syringe, put then plunger in and squeeze urine into a urine cup. We use this technique to check for ketones and specific grav all the time. We also do this without the bag. Just stuff the 2x2s in the diaper. Be sure to check with lab to make sure that they are ok with doing this for the test ordered. We used to use cotton balls but they can leave cotton residue.

Thanks I appreciate the answer:). The 2ml number helps, some nurses were saying more and some less. I have worked mostly with older kids and we always draw 5-10 depending on the kid. The system that I am using now has no marking or indicator line on the tube, you have to add in your own stopcocks and basically create a vamp and then hook up your syringes when you do a draw. Definitely a change for someone who has always used a closed system.

We do the same combo (fent, versed, vec or roc). However we usually don't premed with atropine, even in infants. We just have it drawn up at bedside per physician preference. Also we have a RSI med kit/box that contains all the meds listed plus epi and more.

I just wanted to get an opinion following a discussion that happened at work today. I am used to using a Vamp system with art lines and cvps. The facility that I am working at right now uses a traditional system with a 3 way stopcock. We had a discussion about how much waste you would draw off an art line for a 4kg baby and if you would return that waste. What would you do?