Hey everyone!
This week at the NICU facility I got the chance to shadow an RT (respiratory therapist), a specialized healthcare practitioner trained in pulmonary medicine in order to work therapeutically with patients suffering from various pulmonary issues. In the NICU, the RTs mainly monitor the infants’ breathing or the patterns of the ventilators the babies could be put on. Newborns born prematurely often have breathing problems due to undeveloped lungs but even full-term babies can also develop respiratory issues from a difficult labor and delivery, birth defects, or infection. The RT that I was observing for the day was in charge of the care of multiple babies who were on ventilators for various reasons.
One of the patients had a bone development abnormality that caused the bones in the body to disjointed at points and not in proper shape. I watched as the RT carefully re-positioned and re-taped a breathing tube to the patient’s face as it had been causing minor bruising near the baby’s mouth.
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| Jet Oscillator Machine (a type of ventilator) |
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| A newborn with a breathing tube |
Another baby that the RT who I was observing was in charge of was a baby born at almost 24 weeks gestation. In other words, the baby was born by emergency cesarean section 16 weeks (4 months) prior to full term! Often, babies that born at 22 to 23 weeks do not survive after birth, so it was a remarkable sight to see this baby. Many of the nurses came and went to look at this baby because it's not often that a baby so small is seen. So tiny that the baby could completely fit in one hand, it had to rely on a breathing tube as the lungs were too undeveloped to support the body.
As the infant’s eyes were still fused shut, hair covered the head from the back of the scalp down to the eyes, skin was so delicate that touching it normally would leave a mark or bruise, the nurses handled the baby with extreme delicacy. The RT spent about a half hour changing the breathing tube to ensure that the tape or weight of the tube doesn’t significantly affect the baby’s skin. In one of my earlier posts I mentioned a baby that was born 14 weeks premature; however this baby was so much more smaller than one I saw earlier. In the time that the breathing tube was being replaced, the baby also had an x-ray done so that the doctor could see how much of the chest and abdomen had developed internally.
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| A size comparison of a baby at 24 weeks gestation and a hand |
In Pediatric Surgery this week, I spent most of the time observing at the clinic. I sat at the front desk for a few hours observing what it’s like to be part of PFS, patient financial services. When you go to a doctor’s appointment, these are the people that check you in, answer phone calls, manage all the paperwork and insurance information, etc. I also observed clinic appointments for a few hours as I had in previous weeks and interacted with patient families.
I managed to also get more survey interviews done this week, and I’m hoping that by the time this project ends I have more than enough to make an accurate analysis!
Anyways, I hope you enjoyed the post and I'll see you next week! :)
Hi Urmi, you're work is amazing. What are some reasons why the child cannot survive when born at 4 months?
ReplyDeleteHey Ethan! Usually, babies cannot survive when born at less than 4 months because the body is not developed enough to support itself outside of the womb and without the assistance of the umbilical cord. The baby is too delicate at four months gestation to live outside of the womb.
DeleteHey Urmi! It's so amazing to see such an adorable, small, premature baby that can still grow and develop outside of the womb. What are some common reasons that a baby has to be removed prematurely by a caesarean section? Also, what are other organs like the lungs that develop last or towards the end of the pregnancy, and are undeveloped when it is born premature? Thank you!
ReplyDeleteHi Esha! There are lots of different possibilities, but some of the ones that I've been told about is when the mother or baby has a really intense infection, or when the mother all of a sudden becomes unable to support the child for whatever reason, and so on. Another organ that doesn't develop fully until the end of the pregnancy is the skin, which is why babies must be handled with extreme delicacy when premature.
DeleteHi Urmi! Why does the baby with a bone development abnormality need a breathing tube? Those two things do not seem to correlate together. Also, what are the long term effects on a baby that is born prematurely? It's amazing to see that babies can be born so early and survive. Thank you and can't wait to see what next week holds!
ReplyDeleteHey Madeline! That baby actually was born very premature as well as born with a bone abnormality. Since the patient born way before full term, the baby's lungs weren't developed fully so a breathing tube was needed to ensure that the baby was breathing properly. It varies per patient, but often times patients born premature that don't any other issues grow to be normal children. Although this depends on the health of the baby and it's specific situation, sometimes babies born more than 2 months premature can have slower cognitive speed. Awesome questions!
DeleteHi Urmi!
ReplyDeleteIt's incredible to see how technology has enabled such a prematurely born baby to survive! In prematurely born babies, are the organs able to eventually develop completely or will there be long term underdevelopment in these babies? Also, are there any ways in which doctors mimic the environment of the womb for premature babies? Thank you! Hope you have another great week!
Bhumika K.
Hey Bhumika! Although it does depend on a case by case basis, many babies born premature develop and grow to become healthy children. It is possible that there can be long term effects, but often the babies
Deletegrow to be healthy. Doctors and nurses try to mimic the womb environment within the baby's incubator by making it humid and warm within. They also monitor the temperature and oxygen levels to make it similar to that of what it would be like if the baby was in the womb. Also, they try to block out as much light as possible as there is basically little to no light in the womb. Great questions!
Hi Urmi! I think it's pretty amazing that you got to shadow an RT and see babies first hand. I'm just wondering, how will the baby with the bone abnormality be affected as he or she grows up?
ReplyDeleteHey Nichole! Unfortunately, the specific bone abnormality that this baby has will stick with him and he will have to endure it throughout life. I'm sure that will lead to some difficulties as he grows up, but hopefully in the future there will be some sort of treatment.
DeleteHi Urmi! I keep saying this, but it is still so amazing that you get to see all these things! Contrary to what is in your post, what happens to a baby who was born at, let's say, 11 months?
ReplyDeleteHey Liam! That's an interesting question! After 40 weeks (or 10 months), doctors hope that the baby is born asap or they will try to induce labor or do a c-section if needed because the longer the baby stays in the womb after 10 months, the more the chances for complications increases.
DeleteYou get to see so many cool things each week. I was wondering if you are ever able to get some hands on experience working with babies, like the work the RT does?
ReplyDeleteHey Luke! Unfortunately, since I am still under 18 and I'm not a medical student or nursing student, I can't do any hands on work because these babies are so delicate that can't be any opportunity for trial and error. Although I wish I could, I think it's better for now that I observe.
DeleteHey Urmi! That must have been an interesting experience; will the breathing tube cause a long term effect to the babies?
ReplyDeleteHey Ritika! In some cases, the breathing tube can prove to be a negative when excess oxygen exposure can lead to ROP, as I've talked about a couple times in my past posts. But usually, the breathing tube is more of a positive than a negative.
DeleteHello Urmi!! I loved reading about your experience this week!! Does the breathing tube have any severe long term effects on the baby's health? Also, does the procedure alter for more mature babies?
ReplyDeleteHey Siena! The breathing tube doesn't have any severe long term effects. Sometimes overexposure to oxygen can lead to ROP, but that is heavily watched for. Mature babies that are older than 6 months tend to move to the PICU as the NICU focuses on babies that are younger.
DeleteI am so proud of how your project is coming along. Nice work, Urmi! It is hard to believe that a baby can be born at 24 weeks and still survive. The nurses and doctors in the NICU are doing important work. Does the family centered care approach tend to be different depending on if a baby is 24 weeks or say, 6 months? I would imagine that the stress levels might be different for the families and also they might have more limited contact with their child if born extremely early.
ReplyDeleteHey Ms. Conner! Thanks so much! And yes it is different for sure. Infants that are that young as of 24 weeks are extremely delicate which means that often times the parents cannot hold their child the way they would like to or be in close contact. I'd say that from what I've seen, parents with babies that premature definitely have more stress as they are less involved with the care of their child than in comparison to parents of a baby who is months old.
DeleteIt's really cool to see your project progress like this. Overall, do you feel like your project has progressed the way you like it? Or has there been many unexpected problems along the way?
ReplyDeleteHey Adam! I think there have definitely been a bumps in a way like the change of plans for India and the a few minor issues that were eventually solved, but I think overall whatever happened has been for the better.
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