Wednesday, August 6, 2008

What's new this afternoon?

It's all about the As, Bs, and Ds.

A is for "apnea." Apnea is when the respiration rate drops out of normal limits. The monitor alarms are set to go off when the RR drops below 10 per minute. I haven't seen that happen to anyone in the NICU yet, but it's happened to both girls at night when we've been home.  The solution, as I've said, is frequently to administer a poke to the ribs to start the breathing again.

B is for bradycardia, or "Brady" in the med biz. It's a temporary anomaly in heart rate. It happens quite a lot, even to full term babies -- you just can't see it because there's no monitor at home. It tends to coincide with some sort of distraction for the baby, like a hiccup or a gas bubble, or even just a particularly difficult poop. So if you've ever taken a full term newborn home, you might have seen a couple of these a day and never have known it. Anna had one today while nursing. The monitor read "Severe Brady." She got over it.  Apparently the suck-swallow-breathe combo was a bit too much to ask at that particular moment.

D is for "desaturation," or just "desat." The monitors begin to alarm when Anna or Evelyn drop below 88%. I've already talked about what this is and why it's the end-all be-all of life in the NICU, at least for our run-of-the-mill 32 weekers. We've seen it happen now and again. It usually corrects itself without anyone doing anything, or you just calm the baby so it breathes more efficiently.

The NICU veterans hope for days with "no As, Bs or Ds." We're not there yet.

No comments: