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Showing content with the highest reputation since 07/17/2018 in all areas

  1. 2 points
    We are cleaning the skin with chlorhexidine 2% for the insertion of UVC /UAC in extreme premature neonates. After cleaning let the skin dry for at least 30 seconds befor turning any light on the abdomen. We have almost no leasions at the unit.
  2. 2 points
    49 57 posts Report post Posted June 10 Resuscitation: · Receive baby in sterile towel (pre-warmed) and place in plastic sheet (NeoWrap or household plastic wrap) on warmer (Giraffe Poptop) with a warming mattress in place and activated. Our focus at delivery is on keeping the baby warm and limiting movement as much as possible, so a sterile thermal hat is also put in place. · We use gel pad leads in micropreemie size for ECG (NeoTech Micro) and temp probe (Accutemp Plus), and velcro/cloth pulse oximeter probes (LNCS NeoPT-3) Gel pads lose adhesion very quickly in humidiity, and probe positions are changed Q12 hours with cares · Lines are placed and respiratory support tubing is secured before lowering top of Giraffe to isolette position. Humidity is added to 80%, and the ambient temperature is put on "skin" to keep skin temp at 36.5. · Once humidity is effective, plastic sheet is removed and infant is placed in supportive cotton wraps (Snuggle). Linens are changed Q24 hours · UVC, UAC insertion using checklist; clean skin with chlorhexidine 2% without and rinse with sterile saline. For 1st72 hrs of life · Humidity in isolette: 80%. · No bath. · No tape except for ETT securement · Routine diaper care with water wipes. · Score skin health with a skin care score Q6 hours No weights, touch only Q6 hours or when necessary · Transition to PICC at 48 hours of life if no signs of infection.; If skin condition poor, keep UVC if in good position, until skin condition permits PICC (max 14 days). We continue daily linen changes until PICC Is DC'd We continue Q6 hour cares until approximately 32 weeks, or until infant is consistently uncomfortable more quickly
  3. 2 points
    Here the official invite for all of you! See you in Copenhagen!
  4. 1 point
    Relevant questions indeed! I will check with our nursing care specialist also but I think our replies (Sachs Childrens, Stockholm/Swe) are regular hygien guidelines apply, i.e. cleaning with surface alcohol detergent on paper cloth our surface alcohol detergent (70% alc) nursing and our cleaning staff share responsibility for all cleaning (but parents commonly help out too)
  5. 1 point
    I'm working on a practice change for our unit with regard to the human milk spills that are a normal part of pumping for and feeding infants. The obvious solution is to wipe them with paper towels and then sanitize the area, but what do you do when the spot is dried before you see it? Our mothers pump at bedside, and we are often faced with dried spots of milk on the plastic chairs and bedside shelves after mothers have left. Our sanitizers: Sani-Cloth and Oxycide, do not lift the milkfat, and one of them even crystalizes it, making removal extremely difficult.My questions are as follows: 1. What does your infection control say about spilled milk? 2. What solutions do you use to clean dried spilled milk 3. Whose responsibility is it to clean such spots? Environmental services, Nutrition, Nursing, Parents?
  6. 1 point
    I have found timely use of surfactant very useful in MAS, not in all cases only those on very high vent settings and not responding, it help in weaning off from ventilator.
  7. 1 point
    I agree that the data is not convincing, but what bothers me the most is that nobody ever talks about the experience and expertise of the "intubator", I know I can intubate a baby in a few seconds without a problem, been doing it for 40 years, and our group of RT's have been trained carefully and extensively to do the same. Some centers, especially academic centers, allow first year residents to do it with not such good results. I have never used intubation and in the majority of cases nor sedation. I an appropriate intubation, the baby thanks you immediately!!!
  8. 1 point
    Thank you for your comments. @Stefan Johansson and @Francesco Cardona yes he had a probable seizure but no further seizures. CFM for 48 hours all satisfactory. Baby is now extubated and we are normalising his care. I think waiting and watching worked.
  9. 1 point
    Cerebral sinovenous Thrombosis comes to mind. What do you mean by abnormal movements? Were you suspecting a seizure?
  10. 1 point
    Dear all, as @Hamed and @Rizalya figured out, our next Meetup is located to Copenhagen in Denmark, at the Rigshospitalet 7-10 April 2019. With regard to the clues provided: Denmark is (as always) scoring high in the latest World Happiness Report Copenhagen is a city with more bikes than people Rigshospitalet was the scene for the praised TV series Riget by Lars von Trier, where a main character was a choleric Swedish neurosurgeon The statue of the Little Mermaid is one of the main tourist attractations in Copenhagen. The Little Mermaid is a classical fairytale, written by HC Andersen Stay tuned for more information! We'll get back with a lot of details about the Meetup during the autumn, and plan to open the registration in November.
  11. 1 point
    Hi! We use octenidine, unfortunately we only have access to a solution contaning alcohol - although an alcohol-free preparation is possible to produce via the pharmacy. We rarely see necrosis and scarring (although reported in the literature).
  12. 1 point
    No, but we will give bolus surfactant (RDS dosing) after pulmonary hem. with hypoxia
  13. 1 point
    We use chlorhexidine for extremely preterm babies and we use dakin for older ones but never had burns or any other problems for umbilical catheter insertion
  14. 1 point
    We use surfactant bolus but never used surfactant lavage I find the idea only interesting in pulmonary hemorrage ; since we have high mortality , Does anyone have experienced surfactant lavage in pulmonary hemorrage?
  15. 1 point
    I agree with dr hamed! There is no big difference between 4,3 and 4,1 .
  16. 1 point
    I wrote an article in Peds Research in 1992 describing LACK of efficacy of surfactant lovage at 10cc/ kg for MAS. In piglet model. Surfactant was beneficial but lavage never came back with meconium. I tried because of earlier saline lavage studies with worsening of disease with saline washing out surfactant. William Walsh
  17. 1 point
    We use dopamine and donutamine . We use NO but no milrinone
  18. 1 point
  19. 1 point
    Thanks, Hamed. We use Dopamine plus Epi or Dobutamine (sometimes). Interestingly I didn't even thing about NO because we don't have it 😊. Pulmonary hypertension is treated by Milrinone and bicarbonate in our settings. As well we don't use vasopressin as well.
  20. 1 point
    Yes, we are in USA (3 different states I have practiced in)
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