|
Step |
Action |
| 1 |
- Exchange
transfusions must be performed in the Level Three section of the
Newborn Intensive Care Unit by either a Consultant or Registrar/NS-ANP
under Consultant’s authorisation.
|
| 2 |
- Resuscitation
equipment and drugs must be checked and ready for use including
adrenaline 1:10,000.
|
| 3 |
- Ventilator
must be set up ready for use in the unit.
|
| 4 |
- Blood
and IV fluids must be prescribed by medical staff on appropriate
charts.
|
| 5 |
- Consent
must be obtained by the Doctor from the parent prior to commencement
of the exchange transfusion.
|
| 6 |
- Nurse
the baby naked on a radiant heat table, ensuring optimal exposure to
phototherapy and biliblanket if the exchange is being done for
hyperbilirubinaemia.
|
| 7 |
- The
infants cardiorespiratory status and oxygen saturation will be
monitored continuously. Non-invasive
blood pressures will be taken as per RBP.
|
| 8 |
- Aspirate
stomach contents prior to commencement of procedure.
Leave the gastric tube on free drainage throughout the exchange
to eliminate risk of aspiration.
(Baby remains NBM throughout the exchange.)
|
| 9 |
- During
the exchange ensure volume in/volume out balance does not exceed
- 5ml
< 1000g baby
- 10mls
> 1000g baby
- 15ml
> 2000g baby
|
| 10 |
- If the exchange transfusion is stopped for any reason for longer
than 2-3 minutes, disconnect blood line from the baby, remove blood line
from heating sheath, remove line from under radiant heater1.
|
| 11 |
- Observe
carefully throughout the procedure that there is no air in the lines.
|
