Ruth

We have a Network of sorts in KwaZulu-South Africa where the 54 public health hospitals offering maternity services all use the same guidelines, records and clinical governance and audit tools (Essential Package of Care-EPOC) in their neonatal and paediatric units.

I would recommend using skin to skin care to transport them.

We use the Intergrowth charts.

Great idea to have a journal club. Currently although parental presence is encouraged it occurs very seldom in our units.

I am based in South Africa. We tried both the Neobar and Neofit. The Neofit was the better option but agree with the comments above. Having tried both we felt tape was still the better option. We use a barrier film to protect the skin (if available) then extra thin hydrocolloid strips. We then use either zinc oxide or hypofix tape (5 strips) in much the same technique as described above.

What scary experiences for you and ongoing stress working and living in such a volatile country. I pray for peace in Libya and safety for you and your family. I have also twice felt physically threatened in an NICU. The first was a mother who threatened us with a knife and wouldnt let us near her baby. We discovered she had post partum psychosis. The second occurred during a national nurses and teachers strike. Strikers gained access to the hospital and two of my colleagues were attacked in the corridors. They were told that all nurses must leave the hospital. We were informed that the strikers were going ward to ward forcing nurses out. I made a decision that I would not leave and was fearful of being physically attacked. Fortunately the strikers never came to the NICU.

In Kwa Zulu Natal South Africa we are advocating that well at risk term babies are monitored (and if necessary receive antibiotics via short line-hep locked) in skin to skin care with their mother in post natal and are only admitted to the neonatal unit if they develop problems.

Have you considered kangaroo mother care? Once the mother has been taught and understands and practices 24 HR KMC in the hospital- the mother and baby could be discharged to continue KMC at home with follow up in 3 days and then weekly until term and 2500g.

Congratulations and welcome to the family! You couldn't have chosen a better field than neonatal nursing. I encourage you to be actively involved in your local neonatal nursing association and / or to join the Council of International Nenatal Nurses( COINN) This is a wonderful way to gain and share knowledge and experience and to feel part of a larger family of passionate individuals. For a basic introduction to neonatal care the Perinatal Education Programme Newborn Manual is a useful resource: http://bettercare.co.za/books/newborn-care/

There is a physiological dip in glucose immediately after birth but this should be normal by 1 hour. So if the dextrose is low at one hour you should manage it. The practice appears to be treating hypoglycaemia earlier. Some centres are even suggesting 3.0mmol/l. If I remember correctly STABLE is teaching 2.8? Currently we still treat less than 2.5mmol/l

This is the email address for Natalie Shellack. She is a neonatal pharmacologist who has particularly studied the use of caffeine in neonates. I would suggest contacting her. nschellack@gmail.com

Hi Aymen I have many guidelines I can share with you. Please post your email address and I can send them to you.

Hi. We have developed a lot of resources that we can share with you-guidelines, records, audit tools etc There is a good online self study course developed in South Africa -The Perinatal Education Programme http://pepcourse.co.za

These are the charts being used in South Africa RP NN Jaundice assessment chart 2010 NT.ppt

We have an excellent comprehensive chart for all gestations. I can email it to you?

Correct fitting prongs and cap and crucial. Regular checks of nasal perfusion will assist in preventing necrosis. Commence immediately on any baby with moderate/ severe resp distress. Babies can be fed on CPAP. Clamp NGT for an hour after feed then place on free drainage particularly if abdom. Distension present. Keep baby comfortable and well positioined. Sucrose and pacifier work well in keeping baby calm.

I agree. We don't use sedation. Find out why baby is agitated. Pacifier, sucrose/ breast milk, swaddling, KMC, correct fitting prongs and hat etc all work well. Developmental care principles esp. positioining must encouraged.

Neonatal beds These are the norms we are using in South Africa District​​​3 / 1 000 local deliveries Regional​​1,5 / 1 000 deliveries in 2o catchment area Tertiary​​0,5 / 1 000 deliveries in 3o catchment area * Hospitals with 2 levels of care need to calculate the bed allocation for each level on the basis of the number of deliveries in the catchment area of each level. At district level 1/3 of neonatal beds should be KMC, 1/3rd H/C and 1/3rd low care. We also recommend at risk babies are nurses with their mothers and only recommend admitting sick babies to the nursery/ neonatal unit.

Congratulations!! Thank you Stefan for all the work and sacrifice yuo put into making this forum the success it is. I wish I could join you in Stockholm!

I do local neonatal resuscitation training based on the AAP and SAPA guidleines.We are recommending that babies are ventilated with room air for 30secs and then if they do not pink up or respond then to introduce oxygen. Unfortunately fewlabour wards here have blenders yet so this 100%

The Council of International Neonatal Nurses (COINN) together with the Neonatal Nurses Association Southern Africa(NNASA) are pleased to announce that registration and abstract submission are now open for the above presitigious conference. It will be held in Durban, South Africa from 24-27th October 2010. An opening special of R4000 is available untill end of October. www.nnasa.org.za/2010

I tend to use 3.5 for all my arterial lines. NEC can ben linked to arterial lines but I havnt seen any link or association with size

That has been my experience aswell. We dont choose one over the other to go 1st but ensure that the line is flushed between each drug to ensure there is no mixing

We have used double lumen catheters in bigger babies very efectively and certainly have administered blood products with no apparent adverse reactions.

Our bags are kept by the oxygen flow meter above the bed. You have to turn on the flow anyway so it is quick to grab the bag. We do not wrap in plastic as this is time consuming to remove. The correct mask is supposed to be attached and cleaned daily. The bag is cleaned and sterilised between patients. I would also suggest using the neopuff(contollede pressure device) as this is the way we are moving to.