Neonatal intensive care: Analysis of a Case Study Of An Infant in the Intensive Care Setting - Essay Example

Dried and wrapped. Large bore NGT inserted and stomach decompressed. Total 27ml of green fluid aspirated from stomach during resusitation. Intubated with size 3.0 Endotracheal tube at 8cm immediately after NGT placed. Good air entry and chest wall movement but HR slow to pick up too greater than 100 beat per minute by 3 minutes. Inter venus access gained as intubated and 20ml/kg normal saline given. Perfusion good. Bowels wrapped in cingfilm and held centrally over abdomen. Gasps started at 3-4 minutes and regular respirations by 8 minutes.

Active and pink and therefore ETT withdrawn at 10 minuts. Peep of 5 cm H20 applied via face mask, with sats >92% in air. However, marked subcostal recession persisted and nasal flare with grunting and so re-intubated at 16minutes and survanta given in two aliquots at 21 minutes. Transferred to NICU at 40 minutes of age 20/5 rate 40 in air. Sats 97% HR 130. 23rd December was my third night shift of four, the shift started at 20:00 hours. I had been allocated to work in nursery 3 by Sister (Sr) R, where I had spent the previous two nights working.

Working in nursery 3 there was Sr H, Sr R, Staff nurse (Sn) T and myself Sn Still. Sr H and Sn T had returned for the second night shift. As Sr R was coordinating the whole unit, Sr H allocated the babies in nursery 3: Sn Still-preterm ventilated infant (26wk, day 13) and Andrew, an infant with closed Gastroschisis, previously discharged but readmitted following poor weight gain at one month of age with suspected milk intolerance. I took handover of Andrew first as SSr B was preparing to start a feed on Andrew, so hand over was given whilst continuing to do this.

She reported that Andrew had been settled throughout the day waking 3 to 4 hourly for feeds and cares and was on course to feed 150 mls per kilo gram of Neocate, she had therefore removed Andrews monitoring and normalised him, SSr B informed me that Andrews observations were stable and there were