Practical Procedures

Hi 99ers, I am intending to formalise a teaching package for cUSS for both junior medical colleagues as well as our cohort of Nurse Practitioners, so was intrigued as to whether any members already have a teaching in place and how it looks with regard to theoretical/practical teaching and assessment? Many thanks Alistair

Is it more difficult than usual to insert a UAC catheter in 2 vessel cord and are there any reasons why the procedure is more likely to fail in 2 vessel cord situation?

I know initial setting is 8/5 mmHg Th 1sec and RR 20, my question is if there is co2 retention or still there is subcost retraction... What should we do increase pr or increase delta p or rate??? Sent from my MHA-L29 using Tapatalk

Hi 99ers, I am currently working on a Level 3 and we are considering adopting LISA so I would be particularly interested and grateful for opinions and guideline from our European (preBrexit) colleagues who already undertake LISA. Many thanks in advance Al

Dear Colleagues I was wondering whether anyone can provide me with an evidence based article justifying this for neonates in incubators and providing me the rationale. For a baby in an incubator how would a cap and mask reduce infection Alok

Anyone have experience with atraumatic lumbar puncture? Does anyone know if there is a needle available for puncture in neonates? After reading this I am very curious: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32451-0/fulltext

There was an interesting discussion in the 99nicu Slack channel, we'd like to share here, posted by @rehman_naveed The following comments reported a similar episode with a UVC, but alternative explanations were the human factor (was the PICC really backed as intended) and the possibility of material stretching (could the PICC line plastic be stretched while backing?) Also, the possibility of PICC line displacement with arm position was also raised (see https://www.ncbi.nlm.nih.gov/pubmed/16758187) If you have further comments to this episode, please share here!

Hi All i was just curious as to whether anyone had any experience with the Vygon micro site & it's successful use in siting double lumen 2Fr catheters in ELBW? Any experience in general would be greatly appreciated! Many thanks RichMaus

Hi All I just had a question regarding the insertion of pigtail intercostal catheters using the seldinger technique. Our unit currently doesn't use pigtail catheters for ICC and we use the traditional method of blunt dissection down to the parietal pleura then entering the pleural space using curved forceps. Some of the Neonatologists in our unit do use the trochar that comes with the intercostal catheters to enter the pleural space. Our PICU colleagues have recently commented about the this technique and the problems they have found with air leaking around the entry site despite adequate securing of the catheter and dressings. They have suggested we switch to using …