What is the common practice for oxygen use for diaper rash?

[Laurakfels]

When a neonate has a bad diaper rash, we try to leave the buttocks open to air as much as possible, as well as using blow-by oxygen directly to the diaper area. Some nurses use 21%, while others use 100% oxygen. What is the common practice on your unit? Has anyone seen any research done on this topic?

[karnicurnc, MSN, APRN, CNS]

Agree with post above about oxygen and it's detrimental effect. Pumping 100% FiO2 into a preemie's closed incubator can contribute to ROP (think Stevie Wonder). Also oxygen is a drug and I would think it is out of an RN's scope of practice to administer it for this purpose without an order. Just because it has always been done does not mean it is good practice. I would also be interested to see the evidence.

[TiffyRN, BSN, PhD]

We used to use blowby O2 all the time for raw butts. Since about 10 years ago, we have not been permitted to use the blowby (100%) in an incubator (giraffe). In the last 4-5 years, they have frowned on us using anything but medical air blowby.

My personal opinion, the blowby helps only because it encourages the nurses to leave the butt open to air and not encased in what I term the "stool compress". Exposure to air allows the skin to dry out and not stay macerated. Medical gasses may have a slight advantage due to their low humidity. The key though (IMHO) is to allow the skin to dry. Also, when the area is exposed, we are more likely (depending on the nurse), to remove stool between cares, and that is helpful.

Maybe one day when this dratted degree is completed, I'll research this officially. I just have a belief that human babies were not intended to wear diapers, though it is a requirement for our modern society. Not advocating for changing that. Just while the infant's skin integrity is severely compromised.

[BittyBabyGrower, MSN, RN]

We only do it in open beds, I would hope common sense would reign about O2 in a bed. And think about the population age... Usually not a 24 weeker but a full term or older premie considered term who have feeding issues or drug dependency. You could just as easily use air blowby.

[TiffyRN, BSN, PhD]

BittyBabyGrower said:

We only do it in open beds, I would hope common sense would reign about O2 in a bed. And think about the population age... Usually not a 24 weeker but a full term or older premie considered term who have feeding issues or drug dependency. You could just as easily use air blowby.

I agree that oxygen blowby in an open bed just would not affect an infant. But we have some antsy docs who just threw a fit over it. It was not a battle worth fighting in my opinion since I didn't believe the oxygen content of the blowby was the effective agent. We have medical air at every bedside so, no big deal.

[NurseJM813]

The WOCN Society just posted about this the other day. I did some research and this device delivers the oxygen directly to the affected area. It's called RashEndZ

Anyone have any experience with this?

[prmenrs, RN]

I think this came about b/c nurses just grabbed the bag and mask that's @ every bedside and used it to dry the baby's butt. That bag and mask is hooked to an O2 flow meter. I don't think it matters about the O2. You could get an air flow meter, hook up some tubing and use that if you don't want to use O2.