Ultrasound improves care for sick babies

Lori Semeniuk had been holding her newborn son for just a few minutes when her husband, Scott, noticed he was looking a little blue. Physicians in the Grey Nuns Community Hospital neonatal intensive care unit (NICU) soon diagnosed baby Daxon with a pneumothorax. Essentially, a hole in his left lung was letting air into his chest cavity, making it difficult for him to breathe.

NICU staff monitored Daxon’s progress over the next week using a portable point-of-care ultrasound (POCUS), which meant he didn’t need to be moved for repeated X-rays.

“Staff in the NICU would clamp Daxon’s chest tube and scan him before rounds,” says Lori, who arrived daily to hear the physicians’ morning updates. Using POCUS, staff could see the air decrease in his chest over time, as the pneumothorax healed.

The purchase of point-of-care ultrasounds for both the Grey Nuns Community Hospital and Misericordia Community Hospital NICUs was made possible due to donations to the Covenant Foundation from the Sandra Schmirler Foundation.

The ultrasound’s benefits are many, says Dr. Robert Lemke, medical director of the Grey Nuns Community Hospital NICU, who applied for POCUS to be funded.

Previously, babies needed to have multiple X-rays using a portable system, which was more disruptive than using POCUS. Now, it’s easier to assess babies’ lungs multiple times a day using the ultrasound system since it is about as disruptive as changing a diaper.

The Grey Nuns’ POCUS has been in operation for about a year, and clinicians can use it for multiple purposes.

In addition to monitoring the lungs, POCUS is used to assess other organs, including the heart and brain, and it can make intravenous access easier.

“Having around-the-clock access to bedside ultrasound by trained clinicians allows us to care for newborns in real time and make adjustments as needed,” says Robert.

Nate Crosland, the clinical lead for respiratory services in the Grey Nuns’ NICU, deals strictly with infants’ lungs.

“When you’re looking at a lung ultrasound, the biggest question is whether what you see is going to change the course of care,” he says. NICU infants can experience breathing difficulties due to multiple conditions. The treatment plan is established depending on the cause.

“Ultrasound lets us know what we’re dealing with more quickly so we can adjust the treatment plan. It’s about providing more timely intervention for our NICU kiddos,” says Nate.

The availability of POCUS has changed how the NICU operates. The ultrasound is used nearly every day at the Grey Nuns hospital, making it a key piece of equipment that has filled a need and improved care for families.

“By preventing the transfer of infants to other sites for procedures, we’re able to keep the mother/baby dyad together, which brings higher family satisfaction,” says Robert.