Another PIC Bites The Dust

After Jeff held Henry this afternoon, we headed out of the NICU during the 6:45-7:45PM shift change hour because they ask all visitors and parents to leave during that time. We grabbed some dinner and then Jeff dropped me off at the hospital. I had intended to leave by 11PM, but things tend to detain me. Tonight, it was Henry's PIC line.

Emily was Henry's nurse tonight. She's the primary for another baby, Julissa, in Pod Four, so Kathy ended up staying in Pod 2. Emily has taken care of Henry before. We have some lovely pictures of her with him. I started on Henry's cares shortly after I arrived. After taking his temperature, which is taken under the arm, I noticed that his right tricep/bicep area looked a little red. Not awful, but just different, so I asked her about it. She got one of the residents to take a look. He said that Henry's circulation looked fine. He tested it by squeezing Henry's hand, which turned it white, but then the color returned. He suggested, however, having the nurse practitioner take a look. Tonight, Carrie was the NP on duty, but she was doing some other things in the rather busy NICU, so I went ahead and did skin-to-skin with Henry for about two and a half hours. We put Henry back into his isolette around 11PM. The skin-to-skin went very well. He had one brady where I had to lighty stimulate his arm to get him to start his heart back up (as usual, I think he just got a little too relaxed while kangarooing).

Carrie took a look at Henry's arm. She agreed that it didn't look right. Henry was pretty unhappy with her when she felt around his arm. So, long story short, the PIC line needs to be removed and another one put in. PIC line number 5 has bit the dust. She said that it will be replaced in the morning. In the meantime, he has been taken off the TPN and put on a dextrose solution. That was frustrating because Dr. Wispe said today that Henry needs nutrition more than anything else. Although the TPN isn't great, it is better than sugar water. The TPN made for Henry can't be used through a peripheral IV because it has some nutrients that can't be given through it (e.g., calcium).

Emily and Michelle put a peripheral IV into Henry. Michelle asked me if it was OK to put in a scalp IV. I said that I wasn't thrilled by it, but that she should choose whichever location she thought best. She had spotted a nice "juicy" vein on the left side of his head. She tried putting it in but the vein went kaput. So, they ended up putting the IV into his left foot.

As I left around 12:30AM, I saw Nadine talking with Michelle. Nadine stopped by because she had been visiting one of the teenages that she counsels who had just delivered a baby. Nadine works part-time in the NICU and part-time for a pregnancy program for teenagers. I gave her the Henry update. Michelle was surprised when I said that the PIC line was number 5, meaning that by tomorrow, he'll be on line number 6. That's a heck of a lot of PIC lines. The PIC line procedure is a sensitive one. Everytime they put in a PIC line, there is greater potential for infections. When the put in the PIC lines, they wear masks and gloves and use sterile sheets during the procedure. And, everytime they do a PIC line, they have to x-ray him to make sure that the line isn't too close to the heart, but just close enough. X-rays, of course, mean radiation, which they like to minimize as much as possible.

Let's hope that PIC line number 6 is his last. And that the feeds take this time, so that no PIC line is needed.