Advances in neonatal care : official journal of the National Association of Neonatal Nurses
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Multicenter Study Clinical Trial
Recorded maternal voice for preterm neonates undergoing heel lance.
To determine if a recording of a mother's voice talking soothingly to her baby is useful in diminishing pain in newborns born between 32 and 36 weeks' gestational age (GA) during routine painful procedures. ⋯ Different modalities of maternal presence would appear to be necessary to blunt pain response in infants, and recorded maternal voice alone is not sufficient. The loudness of the recording may have obliterated the infant's ability to discern the mother's voice and may even have been aversive, reflected in decreased oxygen saturation levels in the voice condition. Preterm neonates of 32 to 36 weeks' gestation may become sensitized to painful experiences and show anticipatory physiological response.
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Capillary blood sampling is an essential method of blood collection performed by nurses of all skill levels to obtain samples for routine laboratory tests in neonates. Accuracy of results depends on proper heelstick and sample collection technique. Recent advances including development of devices designed specifically for heelstick capillary blood sampling and research into expanded safe heel capillary sampling sites are discussed. A step-by-step guide to capillary blood sampling is outlined along with evidence-based practice incorporating neonatal-appropriate disinfection and nonpharmacological analgesia that contribute to improved infant safety and comfort during and after the procedure.
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Placement of a peripherally inserted central catheter (PICC) is often complicated by the infant's small size and previous use of the peripheral veins, making the traditional means of insertion inadequate. New techniques and technologies, previously reserved for pediatric and adult patients, are now available for use in neonates and can enhance the practice of neonatal PICC teams. ⋯ A second useful technique, the catheter exchange procedure, allows insertion of a new catheter within the same vein when complications such as occlusion, breakage, or inappropriate position occur and require removal of the currently dwelling PICC. Clinicians caring for neonates and infants must continually update their knowledge and skill by incorporating new techniques into their practice.
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Randomized Controlled Trial Clinical Trial
A pilot study of changes in cerebral blood flow velocity, resistance, and vital signs following a painful stimulus in the premature infant.
The purpose of this pilot study was to determine the cerebral blood flow velocity and resistance changes and vital signs following a painful stimulus in the premature infant. ⋯ This is a study based on a small sample size. However, the Doppler-measured peak systolic velocity increases significantly after a painful stimulus. The clinical implication of this finding needs to be established.