Intensive Care Nursery - House Staff Manual

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Use this only in intubated infants. Clothing, particularly a hat, further reduces heat loss. Radiant heaters provide effective heating but create high evaporative water losses. Infants <36 weeks gestation should be placed in an incubator or under a radiant warmer with temperature probe on the skin. , that environmental temperature at which oxygen consumption and caloric utilization are lowest). If an infant <1,500 g must be under a radiant warmer to allow easier access, cover the infant with a plastic wrap (if intubated) and cover the head with a hat.

Preterm infants recover from anemia at 34-36 weeks of gestation. Endogenous erythropoietin (EPO) is released when hematocrit (Hct) decreases to low 20s; reticulocytes increase 1 week later. Transfusion of infants at this point suppresses EPO and delays recovery. Indications for PRBC transfusions: A. Clinical hypovolemia and Hct <40% (see section on Neonatal Shock, P. 101). In an emergency CMV negative, irradiated O negative blood may be given without type and cross match by Attending order. B. , nasal CPAP, head hood O2): transfuse for Hct <30% •Apnea of Prematurity: transfuse for Hct <30% and worsening apnea (see section on Apnea, P.

Keep catheters filled with fluid and free of blood except when obtaining blood samples. As soon as possible after inserting the catheter, begin infusion of heparinized fluid (1unit/mL) through the catheter. 2. Cover catheter insertion site with antibiotic ointment on a dry gauze pad. The dressing should be changed daily and the site inspected for signs of infection. Catheter sites, umbilical or other, should neither be left exposed nor covered with an occlusive dressing, which may cause maceration.