3 year old with trach/mickey tube (fdg)

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Hi...

I have been in nursing for 31 years for the elderly. Now I am doing part time as a private duty nursing for a 3 year old. I need any information out there. Like cpr... vitals... etc. Anything would be appreciated. He does have a trach and a fdg tube but able to eat po.

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Specializes in Pediatrics Only.
Hi...

I have been in nursing for 31 years for the elderly. Now I am doing part time as a private duty nursing for a 3 year old. I need any information out there. Like cpr... vitals... etc. Anything would be appreciated. He does have a trach and a fdg tube but able to eat po.

You came to the right place! I do peds private duty nursing and trachs and g-buttons are now second nature to me.

Elaborate for me though, because I dont understand what you are asking about CPR. You would of had to of had CPR before obtaining this job, and they teach pediatric CPR during the course, so what is your question?

Also what kind of information would you like on vital signs? Elaborate for me just a little and I'll be able to help you better :)

-Meghan :nurse:

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Specializes in Maternal - Child Health.

Please do not accept the care of this child until you have been thoroughly oriented and supervised by an experienced pediatric nurse!

The questions you are asking are so basic that I am led to believe that you have not had any recent pediatric experience (in general) or orientation to the specific needs of this child.

Please, at the very minimim, attend a pediatric CPR course, and shadow one of this child's experienced care-givers. As a private duty nurse, you have no immediate back-up in an emergency. It is imperative that you be skilled in emergency management of his airway, and g-tube. It will also help tremendously if you have an opportunity to establish a trusting relationship with the little tyke and his family BEFORE you care for him independently.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

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Specializes in Med-Surg, Geriatric, Behavioral Health.

Good follow up posts.

welcome4.gif

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I would suggest checking out the Peds forum https://allnurses.com/forums/f41/ there are some good links posted at the top. I would also suggest doing a search for MicKey (or Mic-Key) button as I know we've discussed it before.

On CPR, you need to take the BLS course that includes infants and children, if you've worked in adults it is very possible that what you've had is the HeartSaver course that only covers adults. Unfortunately because there are several differences between adult and child/infant CPR it isn't a question that can be easily answered.

Normal parameters for infant & child VS can be found in any Peds textbook and your agency probably has a handout that lists them. Taking VS on infants and children can be a challenge that it takes practice to overcome. For pulses on infants it is usually easiest to take it an apical pulse for 15-20 sec then multiply it by the appropriate number to get beats per minute.

On children you can do an apical or brachial (the pulse point in the inner, upper arm) for a predetermined amount of time than multiplied.

Most kids with trachs have a pulse ox machine. As tempting as it seems to use the numbers off of it my agency required that a pulse be taken manually and documented at least once a shift.

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HI...

I have had cpr training in adults and peds but to be honest I didn't pay much attention to peds as I never thought I would have to work around them. I know the basics but would like to know a 1-2-3 step so I can remember it better. Besides it changes all the time and i want to be sure. also I was with the caregivers that are now there for a few days (like 2). like nursing everywhere ... you are short staffed. I am trying to review everything I can get my hands on so I can do a good job. pros and cons of the mic-key tube. I know vitals are taken differently than adults. I do better if I see things done. And I did but it was very quick and once.. The mother who is trained and has been with the child since birth is there with me all the time. I have had experience with g-tubes and trachs but with peds it may be different. I quess that is what I am asking. Thanks...;) and the child and I have a good relationship already. That is the good thing. Maybe I am just nervous as I couldn't have children and the last little one that I even babysat is now 22 years old. Just a little unsure of myself.

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thank you to "kids". Excellent information and you didn't make me feel stupid. Much appreciated .:idea: It is such a big change for me and a little scary. I couldn't have children.. so kinda blocked them out so it wouldn't hurt so bad. had 2 miscarriages.

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Two points to remember, if the G-tube comes out, it needs to be reloaced as soon as possible, if you can't get a regular G-tube in, chances are that the mother will also have a back up Red Robinson catheter there just for this reason. Know where it can be found.

Also, watch the mother closely next time that she changes the trach, it is quite easy to do but very scary the first time. Soemthing else that you need to know.

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Specializes in Med-Surg, Geriatric, Behavioral Health.

Moved to General Nursing Discussion forum.

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Specializes in Vents, Telemetry, Home Care, Home infusion.

best info here: aaron's tracheostomy page

written by rn caring for her toddler--still going strong 10 years later!

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I'm sure you will do a fine job with a little review and the mom can probably teach you a lot also, but I have to ask- why? If you have cared for adults all your life why suddenly take on a 3 year old with multiple and complex issues?? I would have just told the family that I wasn't a peds nurse but I'd refer them to the appropriate places to find one and wish them the best. Although you will probably be okay in the end, it does sound like you are putting the child and your license at risk. If something happened and you told the court, "well I've never taken care of a child in my life but I asked some basic questions on the internet..." not good. Why is this particular job so important to risk that? :uhoh21:

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