Practical Procedures

Hello! Could anybody share with me your protocol of umbilical blood sampling in delivery room, if you do it routinely? I wonder what do you check – lactate, pH or any other, in arterial or venous blood. What is your interpretation? What part of umbilical cord do you use? Is it important – the time after cutting the cord? We want to improve this procedure in our clinic. Thank you very much. Daria

Greetings to all, I hope no one minds but this question is a bit more obstetrical in nature and if nothing else someone may be able to point me in a more apprpriate direction. I am curious if anyone is using scalp lactate values rather than, or in conjunction with scalp ph, for fetal surveillance? In particular I am seeking out groups that are using the LactatePro handheld analyzer for this purpose. I have been collecting data for some time now and am considering research possibilities for the future. One of the stumbling blocks I am confronted with is putting together an acceptable quality assurance program for this point of care (POCT) analyzer. Would anyone w…

Dear friends: I have a problem with one pediatrician of my hospital, she is the head chief in the PICU and she want to standarized some rules that we are not agree in my NICU, so I want you opinio if I have to change it, I will. 1.- First of all, how frequent did you change your in line suction system in each ventilate patient. 2.- When you have a ventilate patient with this kind of system, always you have to increase your FiO2 (inspired oxygen) at 100% level, pre and post suction ???, 3.- What happen in those patients that we have in HFOV and in line suction system, did you change some parameters or you leave it like you have it, 4.- Do you have some protoc…

Hi I would like to review with you, what kind of central vascular acess in neonates in managing preterm or term infant with severe RDs/PPHN. sometimes we have difficulty to make central un ombilical venous KT, so we remove it immediatly and we place either jugular or femoral acess for term neonate and Epicutaneocava KT in preterm. But as you know, especially in term neonate with severe PPHN, the time of catheterism is a usual occasion for oxygenation loss. So what do you do in such situation. Thanks Khaldi Ammar Children's Hospital of Tunis PICU

Hi 99 ers, we are currently in the process of revising our policy regarding the management of catecholamine infusion (i.e. management of changing empty infusions via infusion pumps). Can anyone provide me with the latest literature / technique regarding that matter? I have read a lot about this issue (mostly anecdotal informations) and found that there exists various techniques, which are, in most cases, not based upon evidence. Are there any practice guidelines that you´re following in your unit ? any input is greatly appreciated . thank you in advance Cheers Norbert

We are discussing whether we should protect infants from unintentional (primary) radiation, using gonadal shields during chest x-rays. Currently, we do not use such shields. This interesting article was published in Journal of Perinatology (see abstract below) Pubmed-link: http://www.ncbi.nlm.nih.gov/pubmed/17625572 Would be interested to hear your opinions and experiences on this topic.

Hello Neonatologists, Is routine nasogastric aspiration of the stomach done by you, if so why?

What is your practice of securing Umbilical Catheters (UACs or UVCs)? In our unit, we prefer to centrally catheterize all extreme Preterms (<28wks) as soon as they amine from the delivery unit. However, we have seen delays in actually getting the catheters in place quickly enough to offset the in risk of hypoglycemia so, in addition, we prefer to quickly peripherally cannulate the veins first before the Main procedure to offset risk, of delays. In our unit, we have moved away from 'Goal-Post' method of using tapes applied to abdominal wall to using 'Anchor-stitches' to the Umbilical stump skin rather than to the Wharton jelly of the stump itself. Therein lie…

does amy one before did exchange transfusion using only backed RBCs instead of whole blood in case of hyperbilirubineamia

Is it a common practice to give newly delivered sick babies an initial bath before they are stable?