Thursday, December 16, 2010

Tour of the NICU (neonatal intensive care unit)

Last night Neil and I toured the NICU. I didn’t think it would bother me as much as it did. We already toured an ICU early on in the pregnancy…but the midwife showed us a couple of babies that are about the same age as our baby is now. She explained what all the lines going in were for and how the ventilator worked. I think the association between having a 32 week baby in my belly then seeing a 32 week baby in an incubator hooked up to the machines with all the lines made everything seem more personal and real. The midwife was great about answering questions we had about the ventilator, recovering from surgery, and holding the baby.

Q: How do you know when a baby is ready to go off the ventilator?

A: In your case, where there is surgery involved, we wait until the baby is weaned off the pain meds from surgery about 5-7 days because the pain meds depress the respiratory system. The ventilator can totally breathe for the baby or the baby can initiate breaths. The ventilator measures how deep of breath the baby is taking and can top it up if necessary. So when the baby looks ready to breath on his own, we try.

Q: How long is the baby on pain meds from surgery – is it standardized and how do you tell if the baby is still in pain?

A: Yes it is standardized to about 5-7 days and we measure vital signs such as blood pressure and pulse rate for signs of distress. Sleep patterns are monitored – they become disrupted with pain. Because the babies are intubated and the tube passes through their vocal cords they can’t cry. However, they make faces as if they were crying so even though they aren’t making noise, you can tell they are crying.

Q: When can I hold the baby?

A: You can hold the baby when he is stable, you may get a chance during the first week before the surgery but probably not the week right after surgery. We encourage skin to skin contact even with all the tubes, we are just very careful. You need to ask everyday, don’t hesitate. If he is having a good day they will say yes, if he has had a lot of procedures or tests that day that may say no he needs to rest.

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