Total parenteral nutrition - infants: when to get help
Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
If your baby receives TPN at home, follow the written emergency plan from the home nutrition team.
Call emergency services for severe breathing difficulty, blue or grey skin, unresponsiveness, a seizure, uncontrolled bleeding, or a catheter that has broken with significant bleeding.
Clamp the catheter if you have been trained to do so.
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
While your baby is in hospital, tell a staff member immediately about changes around the line, pump alarms, leaking fluid, or a sudden change in your baby's behavior or breathing.
Contact the team urgently for:
Fever at or above the threshold in your baby's care plan
Redness, warmth, swelling, discharge, or bleeding around the line
Swelling of the arm, leg, neck, face, or chest
A damaged, leaking, blocked, or displaced catheter
A cloudy, damaged, leaking, or incorrectly labeled TPN bag
Repeated vomiting, unusual sleepiness, poor feeding, or fewer wet diapers
Pump failure or an infusion that stops unexpectedly
Every sign above is quoted from the sofidex article on Total parenteral nutrition - infants. If you are not sure, err upward — it is always reasonable to be checked.