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Showing content with the highest reputation since 05/24/2017 in all areas

  1. 3 points
    Work becomes more difficult.. https://www.nytimes.com/2017/02/27/well/family/what-happens-when-parents-are-rude-in-the-hospital.html
  2. 2 points

    From the album 99nicu album

    This is an acrylic and ink painting by @Ryan McAdams. Read his thoughtful essay about the painting below.
  3. 2 points
    Wangyang, we find anger & rudeness occasionally, it is helpful to think of it as stress reaction behavior & a possible indication of PP depression in either or both parents. We are considering giving out the Acute Stress Disorder self scale along w/ other info on self care etc to our parents in hopes that it will help them reflect on their situation & find ways to help themselves.
  4. 2 points
    Dear Colleagues, We are advertising 2 Consultant Posts in Neonatal Medicine. We are expanding unit with every tertiary neonatal speciality offered (Cardiology, Surgery, Nutrition, ENT, Ophthalmology, Neurology, Neurosurgery, and Palliative Care). We also host neonatal transport with a commitment for land, and air based transport). If interested feel free to apply and get in touch. The job advert closes on the 24th of June and Interviews are planned on the 12th of July. You will need a UK CCT or equivalent European experience to be eligible. http://jobs.uhs.nhs.uk/job/v715314?locale=en-gb Best Wishes Alok Dr Alok Sharma MBBS MD MRCPCH Consultant Neonatal Medicine Princess Anne Hospital Southampton SO16 5YA To contact email aloksharma@nhs.net or call 00447725868090 188-MT617-Medical_MT617-Medical JD (1).pdf
  5. 1 point
    Dear Dr. Hady, After 5 years of the program now. How can you evaluate it ? In other words, what are the pros and cons of the program ?
  6. 1 point
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  9. 1 point
    S.T.A.B.L.E. is the most widely distributed and implemented neonatal education program to focus exclusively on the post-resuscitation/pre-transport stabilization care of sick infants. Based on a mnemonic to optimize learning, retention and recall of information, S.T.A.B.L.E. stands for the six assessment and care modules in the program: Sugar, Temperature, Airway, Blood pressure, Lab work, and Emotional support. A seventh module, Quality Improvement stresses the professional responsibility of improving and evaluating care provided to sick infants.
  10. 1 point
    Dear all, the 99nicu Meetup is broadcasted live on Periscope. The quality is not superb but you will get some insight in what is lectured and discussed. Join in here: https://www.periscope.tv/99nicu/1yNGaqXpQXlGj
  11. 1 point
    Hi Stefan, Perhaps you have already gone through; still uploading this interesting article I missed before. The Dutch Experience. Best Wishes for the up-coming meet! End-of-Life Decisions in Dutch Neonatology.pdf
  12. 1 point
    There is now only 24 hours until until the 99nicu Meetup starts. The roll-up arrived in time Today, I and @Francesco Cardona are printing and packing delegate folders, preparing USB-sticks and getting snacks for the welcome reception tomorrow night. We are very excited to meet some of you tomorrow IRL, it will be a great meeting! Now back to our work here in the HQ's!
  13. 1 point
    I don’t envy our nurses who care for babies withdrawing from various opiates and other substances. These assignments are definitely a challenge and require a great deal of patience and depending on the shrillness of an infant’s cry a good set of earplugs. Nonetheless we do our best with these infants to keep them calm and avoid as much stimulation as we can as we attempt to minimize the excitability of their nervous system. Over 40 years ago the Finnegan Neonatal Abstinence scoring system was developed to assist medical teams by providing as objective a system as possible to compare one infant to another and determine when and if a patient should be treated pharmacologically. Unfortunately there is a problem inherent with this scoring system. It is the same problem that exists when you don’t have a blinded research trial. Imagine you are caring for an infant and you were given no history about drug exposure. How might you score a patient like that compared to one in which you are told has been exposed to illicit substances? Your senses are heightened and moreover if you were told this baby is “withdrawing terribly” or “is awful at night” you are biased. How are you likely to score such a patient when they are “on the edge” of being counted as a 1 or a 0 in a category? I bet in many cases, especially if you haven’t taken care of many such patients you err on the side of caution and score them on the high side. It is human nature. When the possible outcome of failing to recognize a withdrawing patient is a seizure, no one wants to be on when it happens having their scoring questioned. Have a look at the scoring tool though. There is a lot of stuff in there to check off! What if it could be simpler? The ESC Tool In early May, news began to break of an abstract being presented at the Pediatric Academic Society meeting. The news story from the AAP can be found here. The ESC tool is a three question tool used to assess whether an infant requires treatment for withdrawal. E – Eat (is an infant is able to eat 1 or more ounce per feeding) S – Sleeping (sleep for an hour or longer undisturbed) C – Console (Be consoled in 10 minutes or less.) If all three criteria are met, the patient does not need treatment. If one or more criteria are not met the housestaff are notified and first non-pharmacologic and then pharmacologic means are employed if necessary to control symptoms. The authors did something quite interesting. They looked at 50 patients with 201 hospital days with prenatal exposures to opiates and applied the ESC criteria to guide treatment. Concurrently they captured the Finnegan scores but did not use them to guide treatment. The findings I hope you will agree are quite interesting! “FNASS scores indicated starting morphine in 30 infants (60%). Morphine was actually started on only 6 patients (12%) (p< 0.0001) based on the ESC approach. The FNASS led protocol directed initiating or increasing meds on 24.6% of days compared to 2.7% of days using the ESC approach (p< 0.0001). The FNASS approach directed that morphine was either not started or decreased on 65.8% of days compared with 94.4% of days using the ESC approach (p< 0.0001). There were no readmissions or reported adverse events. Pretty amazing but… The ESC approach greatly reduced the need for treatment and as the authors state there were no readmissions or reported adverse events. What we don’t know and will be needed I suspect before anyone will adopt this strategy (which I have to say again is so much simpler that current approaches) is how these children do in the long run. If the system is undertreating withdrawal, could we see downstream impacts of a “kinder and gentler” approach? One outcome that will be reported soon in the next month is length of stay. I am eagerly awaiting further results as I for one think that a simpler approach to these patients may be just what the doctor ordered. I think the nurses might thank us as well but we will see just how appropriate it is! The Abstract reporting these findings can be found below Novel Approach to Evaluating and Treating Infants with Neonatal Abstinence Syndrome
  14. 1 point
    Really i wish i could attend this conference Please,Can you tell me how much it will cost for 3 days
  15. 1 point
    Hi Every one .. My question is about observership programme .. These kinds of programmes is new for me and i know someone who took it for 2 month in USA when i talked to him he said that was an awesome experience as allowed him to have a closer look on how things done and various issues in Nicu ( Exposure to different cases and new method of management - NO Cooling ..ect ) .. So do you have this programme in your hospital ? if so whats the Pre-requisite ? thank you .
  16. 1 point
    Greetings to all members of this esteemed forum and thank you in advance for your response(s). As a medical student and during my residency training, it was routine to administer vitamin k to every newborn. However, it appears the practice is being abandoned in my part of the world. What is the position in your country regarding this practice? In addition to your responses, if there are recent material(s) to support the position in your country or locality, I will be glad to have have them. Looking forward to hearing from as many members as possible. Dr Okposio Matthias Nigeria
  17. 1 point
    Agreed, we still give vit. K to all our newborn in Malaysia.
  18. 1 point
  19. 1 point
    I guess nothing has changed from a medical point of view, i.e. universal vitamin K prophylaxis is recommended. There is a relatively new position paper by ESPGHAN, here: https://www.ncbi.nlm.nih.gov/pubmed/27050049 ( if you need the paper in full-text, try http://unpaywall.org/ )
  20. 1 point
    Rudeness parents on medical team members ,such situation is somewhat more often happened in my NICU.
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