NICU Equipment and operations ECMO, IVs, and much more

 

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Video taken from the channel: NICU SJMC


 

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Video taken from the channel: Houston Methodist DeBakey CV Education


 

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Video taken from the channel: Larry Mellick


 

Newborn Care Series: Inserting an IV

Video taken from the channel: Global Health Media Project


 

2,000th ECMO patient

Video taken from the channel: Michigan Medicine


NICU equipment can serve many different purposes from monitoring your preemie’s health and vitals to supporting their breathing. One of the most frequently asked-about devices is the extracorporeal membrane oxygenation (ECMO) equipment, so before we look at other NICU equipment and procedures, let’s first look at ECMO. Some of the equipment often used in the NICU includes: Heart or cardiorespiratory monitor. This monitor displays a baby’s heart and breathing rates and patterns on a screen.

Wires from the monitor are attached to adhesive patches on the skin of the baby’s chest, and abdomen. What equipment is commonly used in the NICU? Providers use lots of equipment in the NICU to help take care of your baby.

Each piece has a special purpose in your baby’s treatment. If you have questions about any equipment used to treat your baby, ask his health care provider or the nurses in the NICU. NICUs are equipped with complex machines and devices to monitor nearly every system of a baby’s body temperature, heart rate, breathing, oxygen and carbon dioxide levels, and blood pressure.

A CT scan is a diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more. Some of the equipment often used in the NICU includes: Heart or cardiorespiratory monitor. This monitor displays a baby’s heart and breathing rates and patterns on a screen.

Wires from the monitor are attached to adhesive patches on the skin of the baby’s chest, and abdomen. A CT scan is a diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more.

It begins in the NICU and continues at home. Learn more about preemie care and their special health concerns. Premature babies require special attention. It begins in the NICU and continues at home.

NICU Equipment and Procedures: ECMO, IVs, and More. Medically reviewed by Joel Forman, MD Should You Co-Bed Twins and Multiples in the NICU?The Cardiac NICU at CHOC provides comprehensive care for babies with congenital heart defects, including those complicated by prematurity, low birth weight or multi-organ disease.CHOC is the only hospital in Orange County that performs open heart surgery on newborns.Led by physicians who are dual-trained in both neonatal intensive care and cardiac intensive care, the eight-bed Cardiac NICU. Procedure.

Being placed on ECMO requires a surgical procedure but it is usually done in a patient’s room. The patient is sedated and given pain medication and an anti-coagulant to minimize blood clotting. A surgeon, assisted by an operating room team, inserts the ECMO catheters into either an artery or veins.

List of related literature:

Part 1 will focus on the complications of extracorporeal membrane oxygenation (ECMO), including venoarterial (VA) and venovenous (VV) ECMO and ECMO cardiopulmonary resuscitation (ECPR).

“Mechanical Circulatory and Respiratory Support” by Shaun Gregory, Michael Stevens, John F Fraser
from Mechanical Circulatory and Respiratory Support
by Shaun Gregory, Michael Stevens, John F Fraser
Elsevier Science, 2017

A common model to move such patients is to combine the ECMO team with a standard retrieval team.

“Oh's Intensive Care Manual E-Book” by Andrew D Bersten, Jonathan Handy
from Oh’s Intensive Care Manual E-Book
by Andrew D Bersten, Jonathan Handy
Elsevier Health Sciences, 2018

ECMO is the most labor-intensive procedure in the neonatal intensive care unit (NICU).

“Fanaroff and Martin's Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant” by Richard J. Martin, Avroy A. Fanaroff, Michele C. Walsh
from Fanaroff and Martin’s Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant
by Richard J. Martin, Avroy A. Fanaroff, Michele C. Walsh
Elsevier Health Sciences, 2010

Procedure Cart Aside from endotracheal intubations, the procedures that are commonly performed in the TRS include the insertion of large-bore peripheral venous catheters, chest tubes, central venous catheters, arterial lines, nasogastric tubes, and bladder catheters.

“Trauma: Emergency Resuscitation, Perioperative Anesthesia, Surgical Management, Volume I” by William C. Wilson, Christopher M. Grande, David B. Hoyt
from Trauma: Emergency Resuscitation, Perioperative Anesthesia, Surgical Management, Volume I
by William C. Wilson, Christopher M. Grande, David B. Hoyt
CRC Press, 2007

Extracorporeal Membrane Oxygenation: Infants with MAS make up approximately 35% of those neonates who require ECMO.

“Textbook of Pulmonary and Critical Care Medicine Vols 1 and 2” by SK Jindal, PS Shankar, Suhail Raoof, Dheeraj Gupta
from Textbook of Pulmonary and Critical Care Medicine Vols 1 and 2
by SK Jindal, PS Shankar, Suhail Raoof, Dheeraj Gupta
Jaypee Brothers Medical Publishers, 2011

In addition to stabilization of the infant’s condition (oxygenation and perfusion of tissues), other preoperative interventions, such as nasogastric tube placement for abdominal decompression, pain management, and the maintenance of fluid and electrolyte balance, are implemented to manage specific problems.

“Maternal Child Nursing Care in Canada E-Book” by Shannon E. Perry, Marilyn J. Hockenberry, Deitra Leonard Lowdermilk, Lisa Keenan-Lindsay, David Wilson, Cheryl A. Sams
from Maternal Child Nursing Care in Canada E-Book
by Shannon E. Perry, Marilyn J. Hockenberry, et. al.
Elsevier Health Sciences, 2016

Typically venoarterial (VA) ECMO is utilized to unload the RV while maintaining systemic oxygenation.

“Principles of Adult Surgical Critical Care” by Niels D. Martin, Lewis J. Kaplan
from Principles of Adult Surgical Critical Care
by Niels D. Martin, Lewis J. Kaplan
Springer International Publishing, 2016

Ideally, centers without ECMO capability have prospective criteria to guide the transfer of newborns before the need for ECMO cannulation.

“Avery's Diseases of the Newborn E-Book” by Christine A. Gleason, Sherin Devaskar
from Avery’s Diseases of the Newborn E-Book
by Christine A. Gleason, Sherin Devaskar
Elsevier Health Sciences, 2011

Depending on the dose of radiation calculated, the catheters are after-loaded postoperatively, and if multiple treatments are required, the appliances are removed and reinserted at dose-calculated intervals.

“Pocket Guide to the Operating Room” by Maxine A Goldman
from Pocket Guide to the Operating Room
by Maxine A Goldman
F.A. Davis Company, 2019

A solid knowledge of hemodynamic and respiratory physiology is mandatory to take care of patients undergoing ECMO.

“ECMO-Extracorporeal Life Support in Adults” by Fabio Sangalli, Nicolò Patroniti, Antonio Pesenti
from ECMO-Extracorporeal Life Support in Adults
by Fabio Sangalli, Nicolò Patroniti, Antonio Pesenti
Springer Milan, 2014

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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17 comments

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  • My son was on ecmo when he was born. he swallowed his bowel movement when I was delivering him. My son was 10 lb when he was born and he was very very sick. He is now 27 with no problems this machine really works it saved my son’s life. I was so sacred and heart broken to see him hooked up to all those machines. But so grateful without them he wouldn’t have survived.

  • Great tips!!

    Retired Paramedic here….I always had success using a BP cuff. Apply BP cuff, identify the distal pulse, inflate just until you lose the pulse, then slowly deflate just until you feel the pulse. The idea is to stop the flow in the vein, while allowing the pulse pressure to build up, distending the vein. I been able to get a couple of choices on patients that others couldn’t find anything.

  • My brother is currently on ecmo at the University of Michigan. My family is so scared but we have all of our hope in the machine and these smart wonderful doctors and nurses. <3 thank god for ecmo.

  • ECMO saved my son Sean. He had a CCAM (Congenital Cystic Adenomatoid Malformation). He was put on ECMO on day 1 of life and remained on for 21 days. We are so appreciative for this life saving machine.

  • I worked as a pediatric IV nurse and highly recommend a Wee Sight, they are fairly cheap and can work wonders! Other transiluminators are also available with both red and white lights, depending on user preference. Thanks for the video!

  • My Angel Jayden was also born with CDH & just like this little 1 I was sent 2 another hospital that had ECMO ready 2 go 4 my little boy’s birth in case as they put it he crashed at birth & needed this life saver! Although he did crash at birth & needed full CPR 4 2 mins. 2 bring him back he was strong enough 2 fight without the ECMO 4 18 hours be4 it became 2 much & as we ALL feared the doctors came in & said without ECMO he won’t make it through the night ECMO gave me 23 DAYS it’s bitter sweet!

  • in my nursing college we are using your video’s for education porpuses!! Thank you for your uploads!! You are very kind and helpful! Keep the good work!

  • Great video. I have been waiting for a good video on this topic for years. I learned a lot from watching the cannulation carefully as well as the tips. Could you post a video of some more cannulations? Perhaps with variations such as different sites, dehydrated kids? Thanks for all the hard work!

  • This video is insightful video.if you want to know more detailed information about vein viewer you cant visit the ibis medical,India

  • 4:42 Now when you flush the saline through the trifurcate, should the yellow and white lines be clamped so saline doesn’t get in them?

  • Oh my, she just showed it in. That’s some experience. In my department the doctors do the IVs for all children under 2 years and even after 7 years of experience, I always feel a bit nervous when there’s one that needs to be done. Some children just have too much adipose tissue and no visible veins. Thanks for the tip with 2 tourniquets.

    Great channel doctor Mellick, I wish I could be part of your team!

  • Paramedic in Detroit, I can definitely use this to better my patient care. Thank you both and to everyone who has helped make this video. I find your videos to be very insightful and pertinent in bettering patient-care.

  • This so brings back memories my son was the 22nd baby (the first preemie) and the 19th baby to live from ECMO at Childrens in Washington DC … and now he is 30!!! I can’t say enough thank you to Dr. Bartlett and the Drs. that saved his life.. and now he has TWO beautiful little girls … Thank you eternally grateful

  • How would you stick a long term IV drug user that has wrecked all the obvious places. PIC under the arm? Or is there other options.? IV for pre-op surgery. I’ve always wondered about that. I was watching the baby,and was in awe that that huge needle went in the babies hand. I have narrowing of the arteries and I’m not an easy stick either. Woke up in an ICU unit double pneumonia. I was sure glad I didn’t have to be awake for all that.

  • Hello I was going to see if it was ok if I used part of your video in a tiktok video? I included your YouTube and copyright info????

  • Any chance you and that nurse could do a video on infant/peds urinary strait cath tips/tricks? Seems to be an area that a lot of us non-pediatric ER nurses struggle with. I’d love to hear her advice.

  • I find it super interesting how every hospital does things different in regards to TPN preparation. I know the hospital who started me on TPN which I have now been on for nearly 4 months, have separate lipid and TPN bags and they piggy back the lipids into the TPN tubing which has filters for both sides and an extension (so the tubing is super long compared to normal IV fluids). They change the lipid tubing every day and the TPN tubing every 3 days. They do it like they would do any other IV fluids and do in the same manner but not in a designated sterile field. When I had my line infection and had peripheral TPN through IVs (I am completely dependant on it for nutrition and me going a week without nutrition is not an option; the first day I was there I missed the TPN cut off so they put me on D10 with additives for the night because I have blood sugar problems), I had to be super careful with my IVs. I am a horrible stick anyways because of my genetic condition and how many IVS I have had, but because my anti-fungal and TPN can’t mix and my blood sugar problems (I am talking 40 if TPN gets stopped abruptly) I had to have two IVS at all times in order to be safe. I was seeing IV therapy 2-3 times a day I was going through IVS so fast.