Vitamin K???

[Krista77]

Can someone please tell me when you should administer vitamin k to newborns? I understand to give it soon after birth- but my concern is that I admitted a baby at the change of shift... I did the initial vital signs and assessed the infant. The night shift RN seemed shocked that I had not yet administered the vitamin K. The infant was 1 1/2 hours old at the time of report.

Thanks a bunch,

Cardinal RN

[Mimi2RN, ASN, RN]

Our orders say "on admit", no specific time. As our normal newborns get transferred to post partum at 2 hours of age, it's usually done in the first hour, and preferably in the first half hour of birth. We have a very busy unit, and computer charting, so everything gets done as quick as possible.

When I worked in a smaller hospital, the kids often didn't come into the nursery for one to two hours, so the admit stuff wasn't done until then.

[Krista77]

Thanks! I also found a study that suggested having it done before the 2nd hour after birth...

I just had a night shift nurse kinda give me crap about not getting it done... and I was just curious what others in the same situation would have done.

~Cardinal RN

[dawngloves, BSN, RN]

I recall hearing you can give it up to x amount of time and I'm sure it was more than two hours.(12 maybe???)If you have an unstable kid who needs resusitaion and lines, Vit K isn't really up there. Plus, we have started a policy that the babies must be bathed before Vit K is given, and that's not my priority either.

[Tiny1Nisolet]

I recall hearing you can give it up to x amount of time and I'm sure it was more than two hours.(12 maybe???)If you have an unstable kid who needs resusitaion and lines, Vit K isn't really up there. Plus, we have started a policy that the babies must be bathed before Vit K is given, and that's not my priority either.

Just curious, why do the babies need to be bathed before the Vit K?

Thanks!

[Gompers, BSN, RN]

Just curious, why do the babies need to be bathed before the Vit K?

Thanks!

I haven't heard this. Often our babies are too unstable for a bath until after they're a day or so old, but we give the Vitamin K within a few hours of birth. When we get an admission, our priorities seem to be:

1. Ensure that we have a good airway.

2. Keep that baby warm!

3. Do a quick assessment and get some vitals.

4. Obtain IV access.

5. Draw admission labs.

6. Give admission meds - amp/gent/vitamin K.

A bath comes later when things have settled down.

[dawngloves, BSN, RN]

All newborns in our hospital are bathed before Vit K because of the danger of tranferring blood born pathogenes, (Hep C, HIV). If we are transferring out the kid, we will clean a thigh with betadine, then alcohol before giving it.

That's how I know Vit K can be given several hours after delivery. If it's some 24 weeker, we'll get them all settled and give them a quick wash down while they are honeymooning.

Gompers, all those things you listed we establish during the "Golden Hour" But sometimes that turns into "Golden Two Hours"

[BittyBabyNurse]

I haven't heard this. Often our babies are too unstable for a bath until after they're a day or so old, but we give the Vitamin K within a few hours of birth. When we get an admission, our priorities seem to be:

1. Ensure that we have a good airway.

2. Keep that baby warm!

3. Do a quick assessment and get some vitals.

4. Obtain IV access.

5. Draw admission labs.

6. Give admission meds - amp/gent/vitamin K.

A bath comes later when things have settled down.

This is exactly what we do! Giving the baby a bath can send it over the edge and really stress them out. The ideal time is within an hour. but like Gompers said those were the priorities.

[nicunurse2004]

We give Vit. K with in the first 1 hour of birth and clean the theigh with alcohol before giving. But I beleive that we are supposed to go no longer than 2 hours.

[lovemyjob]

L&D gives ours right after birth, before they go to the nursery. Can be given while mom is holding the baby to help comfort and then the baby can be put to breast to help soothe. As far as blood borne pathogens go, a good scrub with alcohol on the leg does just fine. I don see how some baby soap can clean better than alcohol.

In our NICU, it is usually done before the team brings the baby to us. Its not priority, but on a preemie with fragile veins, I can see how it can be right important to give it as soon as you can (once ABC's have been established, of course.) Doesnt take but a sec anyway.

[RainDreamer, BSN, RN]

When I worked in the nursery, the vitamin K was always done in L&D, that first hour before bringing the baby to us. The protocol was to have the erythromycin and vitamin K done within the first hour.

The c-section babies were brought to us right away from the OR, so we'd administer the vitamin K within that first hour.

In the NICU it's a bit different because there are other priorities, but usually within the first hour or two it can be done.

[BittyBabyGrower, MSN, RN]

Our code team does it before the baby gets to us, that way it isn't missed.

Has anyone gone to IV vit K for the ELBW kids? We have had 2 kids with necrosis in the thigh due to the Vit K, both these kids were like 400 grams? They have no fat and it probably isn't great to give them that route. Our attendings and peds pharm are looking into this as an alternative route for our tiny baby protocol.