Resuscitation

Hi coleagues, I recently came across to a baby in the newborn nursery with what appears clinically as a subgaleal hemorrage (SH). The infant was born at term 2800gram BW, required internal cephalic eversion x3, but no vaccum or forcepts were used. Initial exam was normal except for some scalp bruises. At ~ 8HOl, a significant scalp swelling was noted, concerning for SH( given the boggy sentation of palpation and that is covered all the occiput bilaterally), serial exam showed no significant progression of the swelling, and no extension into the neck. Head Circumsference initially was 33cm and did not increased on serial exams. Infant showed no ssx of shock, poor perfusio…

Dear collegaues! I´m very curious if things have changed and wanted to ask you all around the globe three questions on ventilation in the DR and also in the NICU? 1. What device do you mostly (only) use? a) Self inflating bag b) Flow inflating bag c) T-piece like Neopuff or other d) Ventilator 2. Do you also use some kind of respiratory function monitor and in that case, what parameter(s) do you primaly take in consideration for adjusting your actions (PIP, PEEP, Ti, Vte, Rate, leak%, other)? Yes/No 3. What adjunct to your ventilatory device do you prefer to start with? a) mask b) nasal prongs c) LMA d) ETT…

So I've seen LISA done once, I've now done it once, next is to roll it out unit wide in our NICU. See one, do one, teach one, right? I'd like to hear from those of you that have been doing LISA/ MIST for a while now. What is the best tip you have? What do you know now that you wish you had known when you first did LISA? What barriers to implementation did you have when you started? Any feedback is welcome. Also, I made a video for our nurses and respiratory therapists to just introduce the idea. Not too in depth, but something to get our education rolling. See what you think.

Dear colleagues! Monday Jul 20th 2020 the first successful LISA procedure was made in NICU of Multiprofile Hospital for Active Treatment Pazardjik Bulgaria. Baby girl 28 weeks, 950 grams from mother with chorioamnionitis. Still on CPAP (no ventilation), no Dopamine, looks well, few apneas. I know that nothing is certain but it is a step towards the right direction. Congrats to our team!

Hi colleagues, We use PICC in the NICU all the times and seldon have complications. There several emntioned complication from PICC lines, particularly the malpositioned ones. PICC lines at times, as you all know are critical in the management of preemies and it is very improtant to understand risk and benfits of keeping a line when it is placed. I recently seen a couple of radiology report requesting to remove PICC lines because project into the liver. I though understand that the hepatic vein are very difficult to catheterize with a PICC line (as opposed to umbilical catheter), especially once you have inserted a PICC and is sitting above the diaphragm, if you pull it …

Dear collegaues! I just wanted to hear your opinion doing continuous compressions when the baby has an LMA or do you always synchronize 3:1until intubated? In our national webeducation programme they say that you can "choose whether to synchronize or not" regardless of mask or LMA. Regards Pontus

This series of videos takes viewers through a human factors approach to management of neonatal emergencies. This video addresses the phases of a neonatal emergency which can be compartmentalized into Situation Escalation and Management. The concept is to allow teams to get a multidisciplinary team capable of advanced neonatal life support through escalation so that they can manage the situation. The basic principles of thermoregulation, airway, breathing, and circulation apply to all neonatal emergencies. Certain situations require specialist teams, equipment and specific management. Where possible such situations are managed as anticipated emergencies. Some situations wi…

I wanted to let the 99nicu community have the first look at my latest video. It is based on a ground rounds talk I gave on delayed cord clamping several months ago. I updated it and added lots of animation. You can find the video by following this link: https://youtu.be/6qA3CVGp5Sw The video is not public, meaning you can not search for it, but you can follow the link to view it. I'd appreciate any thoughts on the video, especially mistakes you see or if you felt anything I said was misleading about the evidence. Post your comments to this forum and I will respond. I'm hoping to make the video public depending on this communities comments. Also, I feel a bit wei…

Please help researchers from Germany with their study: https://www.umfrageonline.com/s/175a5bb

Dear fellow doctors, from a practical point of view, how to diagnose pulmonary hypertension in NICU?