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Managment plan , preterm baby

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hi every one

i want to ask you about some areas in the managment of preterm baby :

1- developmental care : whats the advices should be given ??

do you make eye cover ?? how you protect the ears ? what about positions inside incubator ??

2- skin care : do you apply some oil for moistoring ? is there aby evidence support this practise??

3- we dont have TPN ?? so whats other options might help ?A.A infusion ?? whats the evidence ??

4- kangaroo care and Ncpap ? is it ok and what limitation ?

thanks in advance.

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  • 2 weeks later...

This is very very broad topic.

but to answer a few....

1. No eye covers. Sound level of the alarm should be minimal for the staff to hear. Adjust alarm limits specially for each case. we use nesting made from cotton n gauge piece to cuddle the baby.

2.No routine oil application. Skin care is very important, especially for VLBW n ELBW. Applying and removing probes and stickings is a big task and to be impressed on the nursing staff. We use tegadem for ELBW before application of any external probe such as Temp Probe, Spo2 Probe. Thin piece of guage piece beneath BP cuff to cover the limb so that BP cuff doesn't come in direct contact of skin. Cavilon swanswabs to be applied before ET stickings on skin. Removal of all the stickings is also a big task n should be done very gently.

3. If no TPN, Can use AA infusion. As soon as the clinical condition allows. 1gm/kg/day to 4gm/kg/day. Strict asepsis while doing that. Monitor LFT esp TAG Bil weekly.

4. KMC and nCPAP are the mainstay of any preterm care. Protocol depends upon the infrastructure n staff availability, but the world is moving towards non invasive respiratory support. Infact u can use HFNC high flow nasal oxygen before CPAP.

... As I earlier mentioned, pretern care is very vast topic, I can share my protocols with you. Mail me on manpal179@gmail.com

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