30 weeker with PDA

When I first started as a NICU nurse, one of the hardest things for me to learn was when to intervene with a brady and/or desat and when to ride it out. My initial instinct (like most new grads) was to jump in an intervene, and I ended up chasing the sats. Every baby is different, and every unit is different. Some units (and some particular nurses) have a higher tolerance for kids desating, while others jump in within seconds to right the ship.

Unfortunately, there's no clear answer. Even Merenstein and Gardner state that there's very little research on what our O2 parameters for preemies should be; too high and you damage the eyes/lungs, too low and you damage everything else. You have to just go by your unit's standards/orders/policies, and eventually you'll get a feel for it.

My best advice is to ask the off-going nurse what has worked best to address this specific baby's events; s/he will know if this particular baby is likely to bring herself out of it, or if once she hits 70% she's going to need Os to prevent a downward desat/brady spiral. I try to remember to ask this question on all of my kids who are frequently eventing. It's also ok to ask other nurses on your unit for their advice, and just use trial and error (within reason) to figure out the best combo of intervention/waiting for that particular kid on that particular day.