RT Student Blog

Well, I just got home from day 3 (of 4) in the NICU. It further solidified my beliefs that that is where I want to work. I just wish that the one we do our clinicals is at were a little closer. It's about an hour and a half drive from here.

The day started ok. I got there and found out that the night shift had a patient airlifted to a bigger hospital. One of the therapists had to go with them. We also had a patient on the ventilator. Remember, last week we had no vent babies so I was kind of excited to go see. I got to actually suction out the ET tube which is more difficult than you'd imagine with the isolette, circuit, and cables all in the way.

After lunch we got called to the delivery room for a 36 week meconium baby. When we arrived the patient was intubated and the umbilical cord was really green. They said he had been swimming in the meconium for a while it seemed. We got the baby down to the unit and the NNP and doctor struggled to place a umbilical artery catheter and umbilical venous catheter. It looked like I was going to give surfactant (which is like the holy grail for RT students in the NICU here. It's so very rarely done). The chest x-ray came back and there was a pneumothorax. The doctor was preparing to place a chest tube when I left. It's looking like the baby will be on the oscillator (wait til you learn about that one) in the morning. Maybe I'll get to give surfactant then. I'm really feeling like there's no doubt the NICU is where I belong.

Well, I made it through day 2 of 4 in the NICU. I go back next Wednesday and Thursday. Today we had more twins and I even got to set up a baby on a Nasal CPAP. It actually looked a lot like this.

I then got home to find this nice comment "I'm a CF Mom and I got your blog from some of my CF friends out in blog land. I think it's great that you are getting to know new families and that you are getting the word out about CF. Good luck in school. If you have time stop by and check out our family. Melissa is 19 months old and has CF. She is doing really well. Her lungs are clear at this time. She never had to spend any extra time in the hostpial when she was born. She is only on enzymes and vitimens at this time."

Of course I had to go check out The Liberto Blog. I added them to blogs I follow but if you haven't met them, you definitely need to go meet Melissa. She's one of the cutest little girls I've ever met. I look forward to getting to know them and I'm sure you will too.

I usually don't come here after a really long day but today was different. So many of my readers have spent time in NICU's I thought I would check in. First off I must tell you that this unit was huge. It has about 40 rooms.

The day started slow. We had no patients on ventilators and only 2 on nasal CPAP. We went and did the CPAP settings check and entered our stuff in the computer. It was pretty slow. Most of the kids were on a Nasal Cannula so it was no big deal. We had a patient going to the OR to get a bowel resection. Not real sure what that is but me and one of the RT's went to the OR hoping to see something cool. With such a tiny baby the doc, surgical tech, nurse anaeshetist, and anesthesiologist were crowded around so I couldn't see anything. We were there about an hour and a half.

When we returned to the unit the nurse told us that the other RT had gone to a delivery. Twins at 28 weeks. It was about to get exciting. They came in and as is usually the norm the first twin (twin A) was in better shape than twin B. We had ventilators on stand by and a nasal CPAP in each room. I think they weighed about 1200 grams each. We got twin A settled first and focused on B. It (I hate referring to the babies as "it" but I don't want to give away any more personal information because of HIPAA) was grunting and had very noticeable retractions. The baby was in respiratory distress. We got it on a CPAP but the grunting was still present. They decided to give the baby surfactant. That is where you push this liquid straight into the baby's lungs. It helps decrease the surface tension of the alveoli in the lungs so they will not collapse when the baby exhales. The RT intubated the baby and instilled the surfactant. It was an amazing experience to see that.

The rest of the day was relatively quiet. We just basically kept an eye on the babies from then on out. I was a little nervous at first because the babies are so tiny. I had never seen anything like it. You definitely get a satisfied feeling when the babies condition improves. I think this might be somewhere I'd like to work. I still have 3 more clinical days so that opinion could change. I'll definitely tell you more about it.