Learning about PICC Lines and Tongue-Ties!

Hi there! Welcome back from Spring Break, I hope everyone had an amazing time!

I didn't have Spring Break this week, so here's what happened this week, at the halfway point of the senior project!

At the NICU I shadowed a formula tech PCA. Every morning, formula tech prepares the formula based milk for the patients in the NICU and those in other departments within the hospital. Although each patient has their own required formula depending on various factors such as age or weight, the most commonly used one is called Neosure, a 22 cal/oz nutrient enriched formula with increased amounts of iron, vitamins, or protein. The PCA that I shadowed delivered the formulas all around the NICU, sent it to other areas within the hospital such as the PICU (Pediatric Intensive Care Unit), and assisted in feeding some of the patients.

We also traveled down to the “dock”, which is the area in the hospital that contains all of the hospital's extra supplies or materials. The “dock” was massive; I was shocked at how large the room was when we walked in. Although this might be an odd comparison, but it was almost like shopping in Costco, because it was filled with boxes on boxes of supplies on carts and tall racks.

For the last few hours of the day, the person I was shadowing was called to assist in a PICC procedure. A PICC (Peripherally Inserted Central Catheter) line is a thin, soft, long catheter (tube) that is inserted into a major vein that carries blood into the heart. When the tube is inserted, it is pushed towards the heart by threading it slowly up the vein. The PICC line can be used for long-term intravenous (IV) antibiotics, nutrition or medications, and for blood draws. The baby that was receiving this procedure was surprisingly asleep and calm for most of it, even though he was poked a few times with the needle. As veins can curve in the body and it is difficult to predict how a vein could be, the nurse tried a couple times to insert the PICC line but each time the tube either got stuck at a point where the vein might have curved or it got caught within the vein because of another reason.

A PICC line inserted from a larger vein in the arm

At the Pediatric Surgery Clinic this week, I had come to shadow on a day that was very busy. There were back to back appointments, ranging from all types of concerns and reasons. One of the appointments in which I learned the most was with that of a patient who was only a few months old. One of the health concerns she had was Ankyloglossia, informally known as “tongue-tie”. A “tongue-tie” is a problem affecting some babies where there is a tight piece of tissue (known as lingual frenulum) between the underside of their tongue and the floor of their mouth. For infants, this can make it more difficult for them to breastfeed properly, and can create more issues when older such as eating and speaking. As if it is just a piece of tissue, it is removed as early as possible because the younger the patient is, the more delicate and soft the tissues are. Since this patient was merely a few months old, her's was almost like membrane, so it took less than two seconds to cut it.

An Infant who has a "tongue-tie"

Thanks for reading this week’s post! :)