Septal damage in ncpap babies

[uma1ashok]

hi ,

In my icu i find some of the babies nasal septum is badly damaged b cos of the pressure from ncpap though we use deoderm to protect the skin...

any suggestions to prevent it?

what s the practise ? do u also encounter this septal damage?

[babynurselsa, RN]

We used to frequently end up with many one nare babies at a place I used to work. Personally that is one of my issues with NCPAP. THe reason that this happens is that it becomes a life choice for a baby that probably needed intubated. I have seen cpap used appropriately For SHORT periods of time without this result. Also there are other products on the market that do not cause the pressure to the septum that the prongs you are describing do.

I prefer the long nasopharyngeal prongs the babies seem to find these less distressing also. I have also seen small nasal masks like the bipap masks used on adults. these cause no pressure to the septum.

[uma1ashok]

We used to frequently end up with many one nare babies at a place I used to work. Personally that is one of my issues with NCPAP. THe reason that this happens is that it becomes a life choice for a baby that probably needed intubated. I have seen cpap used appropriately For SHORT periods of time without this result. Also there are other products on the market that do not cause the pressure to the septum that the prongs you are describing do.

I prefer the long nasopharyngeal prongs the babies seem to find these less distressing also. I have also seen small nasal masks like the bipap masks used on adults. these cause no pressure to the septum.

thanks buddy !will talk about the use of mask in my area.....

uma.

[dawngloves, BSN, RN]

We have seen a decrease in septum damage since we started using Aladdin. We have been also been using the masks rather than the prongs and I can't recall a kid with a bad nose since.

[fergus51]

At my old facility we used the thick duoderm, changed from mask to prongs at least every 3 hours, during that time massaged the septum and gave the baby a few minutes break by just giving blowby from a mask. This all had to be documented. We hardly ever had problems. If we did see the septum getting nasty looking, we changed what we were doing (intubation, vapotherm, nasal canula).

[kitty29]

We use cpap cannula's by Hudson RCI, and a hat by Sechrist(there are several sizes). We secure the tubing with velcro foam restaints cut to go between the opening, and use a chin-strap, on bigger babies we have made something to also go around the back of the baby's head to help secure the tubing.

Our RT's, nurses, & doctors have worked long and hard to get something to work to prevent problems. We extubate to ncpap early and have quite a few of micropremies. (I'm caring for two tonight!).

Our ventilators for ncpap right now are iflow & istar, but we will be changing to something else soon. We have sometimes also used a high-flow nasal cannula which we divised ourselves also....or I should say RT has.

In addition we check and chart "nasal septum gap" hourly. We used to have a huge problem with breakdown, but really don't anymore.