Rsv

NicuGal, MSN, RN · Jan 15, 2002

RSV to adults is a cold..to a kid that is a former preemie, any lung problems it is big trouble. Most of the time they are on aerosals, O2, occasionally an antiviral. The worst ones end up in PICU on the vent.

kabarnes · Apr 7, 2002

I have taken care of several RSV babies. Warning to you, I started getting kind of lax on the procautions thing, and I ended up with a mega cold for three weeks, I never thought that I could produce so much "snot". Anyway, all of the little ones I have taken care of have done allright, however, some have given me quick a scare. They can't blow their noses like we can.

boobaby42 · May 11, 2002

RSV, respiratory syncytial virus, is a fancy name for a cold. But in infants, it can develop into respiratory arrest in a second. Babies can't effectively cough up the thick mucous that develops with RSV. They cough so hard, they are too tired to drink, so dehydration is a complication. But, most rsv pts will do ok at home with the help of nebulizers, expectorants, fever meds and po fluids. If a premie gets rsv, you have another situation all together.

There is a preventive med., Synagis ( or something like that), that should be given to premies prior to rsv season. It is a series of 5-6 shots given monthly. It costs about 1000 dollars a shot, so good luck getting insurance to pay. In order to get through rsv season without too many admissions of rsv babies to the picu, you should identify the risk population, contact the parents and get their ok for preventive care (synagis), contact their insurance company and argue for weeks to get the medicine approved. If you get the medicine covered by insurance, order the med early.

Alot of information you didn't ask for. sorry. : )

plumrn, BSN, RN · Feb 12, 2003

This is great information. We rarely have pediatric pts, but am told this may change soon.

Are the isolation procedures pretty much mask and gloves any time entering the room? Or just when in close contact w/the pt?

I think Peds nurses are awesome!

Mimi2RN, ASN, RN · Feb 12, 2003

I would mask and gown...we get calls to start IV's sometimes on the RSV babies.

Peds tries to have one staff member take care of those patients, and puts the babies first of all in the isolation rooms.

I give the RSV lecture before babies go home.....don't take newborns, esp. premies to crowded places....keep them home as much as possible, limit visitors, good handwashing, and keep snot-nosed children away from them!

RNbeach, ASN, RN · Feb 12, 2003

Pediatric Nurses are Awesome!

My daughter had RSV 2x's which led to a Pneumonia! It was horrible. she was 4 months old when it happened.. we went in January right after new years. back again 2 weeks later, back again 3 wks later with pneumonia! I thank God for the nurses in that hospital. they were incredible.....

She was soooo chubby they had to get a NICU nurse to start her IV...

She was kep in a mist tent during her entire stay at the hospital and they had a respitory therapist come see her a few times a day/night for nebulizer treatments..

I don't ever remember the nurses wearing any protective garments..however my daughter was in isolation from the other children.

When we finally got to take her home. I kept her away from everybody except the immediate family for till April!

nurs4kids · Feb 14, 2003

I'm a bit confused by the isolation suggestions here..

we only use contact isolation with rsv pts..not droplet, no mask necessary

good handwashing is the greatest defense.

WalMart_ADN · Feb 15, 2003

we use contact for RSV, supposed to wear a gown and mask when we are doing some invasive stuff (IV's, suctioning, getting in the kiddos' face for any length of time) but i agree, handwashing is the best defense.

RSV babies are scary things. I've had an RSV admission get 2 nebulizers, no O2 requirement, and home the next day, then there's the RSV baby i sent to PICU for a respiratory rate of 108. it's amazing how the same virus can affect kids in such different ways. I am SO looking forward to RSV season to be over, my hands always itch when i get home from holding all that albuterol( 6 kids all with q 2 hr nebs over 12 hours can lead to quite the albuterol headache) and i feel so sorry for those babies that are working so hard to breathe. i also find it amazing how cupping (PD & C)can help some of these kids so much more than others.

kids · Feb 15, 2003

Originally posted by WalMart_ADN
... i also find it amazing how cupping (PD & C)can help some of these kids so much more than others.

I am so glad to hear that CPT is still being done in *some* places. The kids at the (home care) job I just left are ALL trached and most of them are vented. We do CPT on those kiddos BID routinely unless there is some sort of contraindication. When they would end up in the hospital (all went to the same hospital and always to the PICU-no trachs/vents on the floor) it was an ongoing fight with the staff to get it done...hospital policy, "research has shown" or some other BS that is was not necessary.

We would bring a kid home ("they are stable & afebrile on PO abx so hey...lets send them back for the home care nurses to take care of") with cruddy lungs, yellow secretions, O2 bled into the vent at 40% FiO2 and Q 2-4 hour nebs . Amazinglyafter being home for 24 hours getting Q 4 hour CPT they would have clear lungs, white secretions and be off the O2 and nebs.

nurs4kids · Feb 15, 2003

We're still BIG fans of CPT. I can't imagine a hospital NOT using it for peds since respiratory compromise is our biggest fear.

After some afterthought, I agree with the mask usage for RSV. Lately, we have had babies admitted with possible RSV, placed on contact precautions pending the RSV results. RSV results come back negative...pertussis results positive. Mask a good idea after all

IRISHBREAD · Feb 15, 2003

we get up to 5 or 6 babies a week during the height of rsv season. big brother/sister brings it home from school and many get from day care. the biggest thing besides neb treatment is to suction, suction, suction. if the kids can't drink we start iv therapy. and when they do start to drink i give 1/2 strength formula and increase the strength as the secretions decrease.

synargis is given to premies and is covered by insurance if they meet certain cryteria ie age, weight, if they were or a vent at birth, any lung problems. but even that does not stop them from getting rsv. it will decrease the symptoms if they have received the shots in time. we have had 2 premies come to our unit with rsv after the shots. rsv can be scarey--if the secretions do block the airway be ready for a code.

i should have thought of this earlier Nursing Spectrum has an educational piece to earn ceu's titled brochioltis which discusses the cause and treatment of rsv. :nurse:

May those who love us, love us

And those that don't love us

May God turn their hearts:

And if he doesn't turn their hearts,

May He turn their ankles

So we'll know them by their limping

An Irish Prayer