Assessment of babies for car seat safety before discharge Flashcards
What percentage of preterm infants fail testing
11-60%
Which population are at a higher risk of SIDS
preterm babies, particularly born at very low birth weight
There has been a decline in SIDS over the last 25 years in larger babies, but this decline has not been seen in preterm babies.
Is there anything that can predict SIDS or a risk of SIDS in preterm babies being discharged
No
Apparent cardiorespiratory abnormalities in infants born prematurely are common at the time of discharge, however there are no monitoring criteria that predict an increased risk of SIDS
Who should be tested in their car seat
AAP: less than 37 weeks at delivery
ALSO: genetic abnormalities, previous concerns re desaturation/apnea, hypotonia
CPS: there can be no specific recommendation. However, the above seem reasonable
Do desturations in car seats matter
Good question: unclear
The significance of periodic episodes of oxygen desaturation to overall health of the baby remains unknown
What should we look for in the car seat test
use oxygen saturation.
if the sat monitor is poorer quality, you can also use cardioresp monitor
No clear rule but the following seems reasonable:
LOOK FOR: 2 or more episodes of desaturation less than 88% x 10 s during a 90 minute period
What do you do if the baby fails
re-test in an approved recumbent car seat
reconsider safety for discharge
Some people use theophylline and O2 to treat desaturations pre discharge.
On average, if a baby fails how much longer will they stay in hospital
1 - 20 days
What do we tell parents re car seats
Supervise the baby when they are in the car seat
Make sure they have the proper support and positioning while in car seat
restraining devices should be as per current standards
What else can parents do to protect babies from abnormal desaturation events for preterm babies
Until one month corrected (if preterm) or babies can sit independently (if hypotonic) : avoid baby slings, snugglies and other infant seats
