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cmcdermott last won the day on April 3

cmcdermott had the most liked content!

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About cmcdermott

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    ANP Neonatology
  • Affiliation
    The Rotunda Hospital
  • Location
    Dublin, Rep. of Ireland

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  1. We use heparinised Glucose 5% in our UACs however the down side is that you cannot use the glucose measurement.
  2. We will shortly be changing our standardised lipid infusions from syringes to bags which will have a 48hr hang time. Several units in Ireland have already adapted to a 48hr (over several years) hang time for an aqueous bag and we have not noted any increase in infection. Theoretically it should reduce the risk as you are breaking the central line only once every 48hrs as apposed to every day. Despite initial concerns from the neonatal nurses they have embraced the change and are looking forward to changing the lipids to 48 hours as well. The biggest risk is that when the lipids are infused
  3. We are in the process of setting it up and plan to use for infants <32 weeks mainly because that is the gestation we send a nursing team from NICU to attend and they will set it up
  4. We use chlorhexidine 0.05% solution for Umbilical lines and some PICC lines and take great care to ensure that the solution is only applied to the smallest area necessary and does not spill down the side of the baby and under their back. We have rarely seen burns with this concentration.
  5. We change the aqueous portion every 48 hours (lipid every 24 as per manufacturer but that is potentially to change) and have been doing so for several years with no issues. The practice is being recommended in the National Guidelines for Parenteral Nutrition in Neonatal and Paediatric settings. There is no good evidence to suggest it is harmful and indeed the 24 hour change of infusions and administration sets seems to be based purely on custom and practice. We have made considerable savings too. The bags have to be clearly marked with a label stating date and time they are hung to avoid
  6. In out unit the nursing staff prepare the medication in a designated corner of the unit. Fluids are prepared and giving set primed at the cotside
  7. We also do not use heparin or locks but run an infusion at 1ml/hr. If not required we remove the line ASAP
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