pooperscooperrn0624

Routing suctioning isn't necessary in most cases. We insert og tubes to open drain for decompressiong and only suction if infant is spitting and choking on mucous or swallowed blood.

I assume NRP guidelines are the same there as here in the states, but I am not sure. I am an NRP instructor here and I think what the "not suctioning" is referring to no longer suctioning before delivering of the shoulders during meconium delivery. Also, though I think evidence has proven that PPV on room air is sufficent in most cases at delivery, the AAP isn't wanting to stick its neck out that far. As far as oxygen delivery is concerned- term infants that are cyanotic recommendations of 100% or any time PPV is given. It also states that if O2 isn't available to use PPV on room air (??what other option do we have!). Recommendations on infants less than 32 weeks is to use a blender and pulse ox begining between 21-100% stating there is no evidence study to recommend particular staring point.

Has a modified barium swallow or upper GI been performed on this infant yet?

Ideally we like to remove umbilical cathers within a week. However, with an unstable VLBW infant we have left them in several weeks while culturing for infection.

First I wanted to address the initial post of inserting the feeding tube with each feed. If we have an infant who require more than a brief og feeding, we always use silastic og tubes which can be left in place for 30 days. Since the silastic is softer it doesn't carry the risk of perforation the other tubes have if left in for longer periods. I have worked in several level 3 nicu's and have seen many different views on this subject. Most neonatologist feed within 48 hrs of birth even with UAC/UVC's in place, though the current place I work never feeds with belly lines in. Even with micro premies we usually have trophic feeds going to stimulate the gut. However, again the place I currently work is slower to initiate feedings.