Practical Procedures

Hi everyone! I'd like to know how you manage and replace daily PICC and UVC (Umbilical Venous Catheter) lines. Have you some particularly attention or procedures to do that? In our centre we usually prepare a sterile field, and two nurse in sterile dress prepare the new lines for all the babies, and this is such a big waste of time. I don't want to speak about the iincreased percentage of probable errors in doing it like this (in terms of clinical risks), but i'm interested in how you manage this procedure.Do you know also some articles in literature, or some evidence based practices rather that some studies that can help me? Thank you!

(1) What dextrosity we can use through PICC catheter? We are using 25% if catheter is at the junction of SVC/IVC and rt atrium, 20% if in deep vein and 12.5 % if in peripheral veins. (2) For how many days we can keep the PICC lines? (3) Is there any need for routine blood culture (PICC) to be sent ?

dear Colleages Can we insert a picc line in an already insrerted cannula like 1 or 2 days before. is that possible , anyone doing this.

Hi Everyone, It has been the recommendation in the past and up to now to apply warm compress on the reddish area for PICC with phlebitis for 24-48 hrs. My question how do you apply the warm compress? What we do in our unit, we pour warm water into a clean glove. We will test the temperature of the water in the glove on the sensitive skin part of the arm.We then make a knot at the end of the glove then wrap the glove with clean thin wipe before applying on the reddish part of the PICC. We change the water and glove with every care. We will assess with every care and we will make our final assessment after 24 hours whether the phlebitis subsided or disappeared or worsen…

Is there a contraindication exists for applying local anesthetic cream before inserting needle for blood collection? it will definetly reduce the pain of big needle prick for the donor. I know there is no contraindication to use local anesthetic cream for day to day IV & blood collections. I want to know why this denial for the donors? dr.r.selvan

I would like to know how UAC/UVC/PICC insertion procedures at your unit for ELBWs. Do you insert them on the radiant warmers or in incubators. Are the babies still in plastic wrap ( from resus)? If its inserted inside the incubators, how do you drape etc. any videos or pictures ?

I was wondering if anyone had policies regarding the TKO rate for PICC's once the baby is currently on full feeds. We have a couple different methods and I am hoping to standardize the way we keep these tiny lines open including: - 1 ml/hr on buretrol pump (with bag of fluid) - 2 ml/hr on buretrol pump - 1 ml/hr on syringe pump Our theory is that with the consistent pressure on the syringe pump, the rate can be decreased. I have yet to see a PICC clot off with any of these methods, but am wondering what other NICUs are doing! Thanks Courtney

Hi there, My neonatology attending asked me to ligate a baby's preauricular skin tag. She acts like it's no big deal. I don't feel comfortable with doing this non-urgent procedure that could easily be taken care of as an outpatient with a plastic surgeon. It's on the baby's face and minimal scarring would be ideal. My question is: how do other units manage the cosmetic aspect of a baby with a preauricular skin tag? Do you take care of it while the baby is in the unit or discharge the baby to have them follow up somewhere as an outpatient? Do you ligate extra digets?

We are changing to Hudson prongs for CPAP delivery and will be following the Vermont Oxford technique of securing them to a knit cap using safety pins and elastic bands. Some staff members have concerns about using safety pins. This method has been used for several years and in many institutions, so I'm hoping that someone can respond with their experience. Has anyone had any problems with infant injury using safety pins on the CPAP cap? Thanks.

hi all Which PLA (peripheral arterial line) do you use to take blood sample for premature (EVLBW)? How do you insert it and you take care? Thanks