Preterm Childbirth Redefined.

[ERDoc]

It's the hyperoxemia that is the problem. Oxygen that touches the eye never reaches the retina.

[scubanurse]

I thought we were supposed to avoid oxygen in the eyes as well...saw a resident get chewed out for that on my L&D rotation a while back?

[ERDoc]

Who chewed out the resident? My guess would be someone that doesn't understand the current knowledge about the pathophysiology of ROP. It is good practice not to blow oxygen into the eyes as it can dry them out and babies don't know how to deal with it.

[scubanurse]

The NICU nurse... I'm going to read up on it even though it's pretty irrelevant where I'm working now. It happened during my L&D rotation last year. I knew too much oxygen wasn't good but not that much about the link between oxygen and ROP, just to not over oxygenate a baby, but if they're blue and whatnot then yeah they need oxygen.

[ERDoc]

I obviously do not know this nurse so I am not qualified to pass judgement but my opinion is that she does not understand the pathophysiology.

[scubanurse]

Which explains why I was confused by it Thanks doc!

[iStater]

ROP primarily pertains to "premature" infants and abnormal eye vessels to which prolonged hyperoxgenation can be an issue. For a full resuscitation or a term infant this will not be an immediate issue.

The chewing out of the resident might have been due to not following the current guidelines from NRP which may have been instituted in that L&D. The gestational age will also play a role as to which oxygen pathway to follow as will hx for CHD, fetal monitoring, the delivery and of course presentation. If a resident is to be present for resuscitation in L&D they need to already know the basic protocols. Blue initially does not indicate oxygen immediately. It depends on where they are blue , tone, hr and respiratory effort after stimulation. The pulse ox is also a guide now where as before it was the APGAR score components.

Edited October 25, 2013 by iStater

[scubanurse]

Interesting. We weren't allowed to do much with the newborns if the NICU team was called in, only the healthy ones. NICU is something that used to interest me but now have little interest in it or L&D, but think it's a pretty cool specialty.

[island emt]

nothing about 400 lb whales reproducing interests me at all..............

[ERDoc]

ROP primarily pertains to "premature" infants and abnormal eye vessels to which prolonged hyperoxgenation can be an issue. For a full resuscitation or a term infant this will not be an immediate issue.

The chewing out of the resident might have been due to not following the current guidelines from NRP which may have been instituted in that L&D. The gestational age will also play a role as to which oxygen pathway to follow as will hx for CHD, fetal monitoring, the delivery and of course presentation. If a resident is to be present for resuscitation in L&D they need to already know the basic protocols. Blue initially does not indicate oxygen immediately. It depends on where they are blue , tone, hr and respiratory effort after stimulation. The pulse ox is also a guide now where as before it was the APGAR score components.

Or it could be the resident was trying to practice medicine while the nurse was following a protocol.