hi ..

i dont know if iam in the right place to post my questions ..

my friends .. whenever i come across a critical baby ,and with limitted facility , i feel sad that a lot of babies in my country died without knowing what was the cause !

working in neonate in libya (third world ) is a bit difficult , its annoying to face problems daily with no tools to stand up against them.

here : frequently , we are presuming diseases rather than diagnosing them.

for example :

RDS with no improvment after surfactant , and with no echo technology , we presume PPHN as the main culprit and starting mg-sulphate is the next step (most of the time ).

i want to ask : have any one been in such a situation ? is there a helpful equations help to differentiate (for example) :lung parynchema problems from V/Q mismatch ?

i opened Gomela : there is a lot of equations but difficult to apply .

sorry if i couldnt convey my thought clearly , but please if you have some ideas to help in this difficult situation in general and also to that example posted above.

thanks.

Do basic things like prevent hypothermia, hypoglycaemia, give oxygen, cover antibiotics, and above all strict hand hygiene. Don't be disheartened by high tech equipment of developed countries. Neonates also die here as well with severe PPHN, NEC etc

Basic steps of resuscitation and proper ambu bag technique is all that necessary and then CPAP. Very rarely kids need intubation. Hope I answer your question

This is our neonatal guidelines in EGYPT and it is suitable for limited resources Nicu

http://www.mediafire.com/view/vzzqu3nbn7v704m/Neonatal_Care_Protocol_for_Hospital_Physicians.pdf