
Everything posted by Francesco Cardona
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Ultrasound guided vascular access and deep access PVC.
Hi Pontus, agree with all comments before. we have lots of experience with US-guided central lines, less with peripheral (but some) and arterial lines. It is only done by doctors at our department. We use both approaches: out-of-plane and in-plane. Regarding the canulas: we use both, most commonly we use the neoflon/venflon. but personally I think the one on the left is superior as it is a lot sharper and has less issues with not being able to puncture the skin or vessels adequately. Though my favourite is the Jelco iv. Once you use it you dont want to go back - especially in kids with thicker/tougher skin. Although it needs some practice as it does not have the "wings" of the neoflon which allows for a better grip. We have some experience with the guidewire, it comes in handy at times, but needs some practice to handle optimally. Although aimed at adults, I think this article has lots of good practical advice: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9886173/ or also here https://www.pocus101.com/ultrasound-guided-peripheral-iv-insertion-placement-and-access-made-easy/
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Should every newborn be tested genetically?
You might have come across this editorial in the Journal "Nature Medicine". Most countries have implemented newborn screening and with affordable genetic testing available, there have been studies looking into screening with genetic tests. But what should be tested for? How do we handle markers for diseases that occur later in life? How do we deal with the emotional aspects for parents, children and care givers? And how do we deal with requests from third parties? https://www.nature.com/articles/s41591-024-03227-9
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Webinar on surveillance of hospital-acquired infections in the NICU
Very interesting, thanks for sharing!
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SURVEY: Seeking intensivists views of ethical challenges of rapid genomic sequencing
Very interesting study. Looking forward to the results and further work on this topic!
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Antibiotic choice in 22 week babies
We give Ampicillin / Gentamicin. Dose of Gentamicin is 5mg/kg first dose, then 36h later 3.5mg/kg @24h intervals. Step up from Ampicillin if there is evidence of other bacteria (resistant?) from mother
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Survey: vital sign monitoring systems
Done 🙂
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Survey on post delivery room care
Done
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Transport Issues
Francesco Cardona replied to Francesco Cardona's post in a topic in Support NICUs in Ukraine's DiscussionsIrish colleagues airlifted Ukrainian patient to Ireland. https://twitter.com/transport_neo/status/1505611005312831494?s=20&t=fP2I3GwnBeaK60jwfwvomA
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What is the current situation for NICUs in the Ukraine?
Francesco Cardona replied to Francesco Cardona's post in a topic in Support NICUs in Ukraine's Discussionshttps://www.euro.who.int/en/media-centre/sections/press-releases/2022/who-is-working-day-and-night-to-keep-medical-supply-chains-open-and-preserve-ukraines-health-system
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Transport Issues
Please add any information or resources you have for transporting infants or pregnant women out of Ukraine. We have compiled lists of material for example. Here is a list of needed items for neonatal transport as recommended by Rosemarie Boland, Australian Neonatal Transport Nurse https://twitter.com/piatkat/status/1501482359748706305?s=20&t=RiFIoWIiu5ak4M6HUWYnhw https://docs.google.com/document/d/1vA1Ixm-j7LtbU5nrGULW5zZE5avklXLnRpv9ihsDBlk/edit?usp=sharing Equipment list for neonatal transport.pdf
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What is the current situation for NICUs in the Ukraine?
Francesco Cardona replied to Francesco Cardona's post in a topic in Support NICUs in Ukraine's DiscussionsIrish news have shared images of maternity ward / NICU in the basement of a hospital in Ukraine Twitter link
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What is the current situation for NICUs in the Ukraine?
Francesco Cardona replied to Francesco Cardona's post in a topic in Support NICUs in Ukraine's DiscussionsA report in Time magazine on the situation in the children's hospital in Kyiv https://time.com/6152374/children-hospital-kyiv-ukraine-russia/
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I can offer help!
What is the best way to contact travel nurses best?
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What is the current situation for NICUs in the Ukraine?
Francesco Cardona replied to Francesco Cardona's post in a topic in Support NICUs in Ukraine's DiscussionsUNICEF has also called for action to help children who are currently threatened due to the war in Ukraine https://www.unicef.org/emergencies/conflict-ukraine-pose-immediate-threat-children
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What is the current situation for NICUs in the Ukraine?
One of the first reports was from a NICU in Dniepro, Eastern Ukraine, featured staff caring for babies in a bomb shelter during the first days of the invasion (feb 24 2022). https://www.nytimes.com/live/2022/02/24/world/russia-attacks-ukraine/newborns-at-a-dnipro-childrens-hospital-moved-into-bomb-shelter
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Family-center care - a 99nicu webinar series
Excellent!
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Family-center care - a 99nicu webinar series
It says Webinar 1 on both 🤔
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Chest Drain Removal Assessment
Very good topic. I agree with Stefan. CLAMP -> X-RAY (after a few hours) -> PULL I would probably adapt the time frame if it was recurrent or there is concern of recurrence or the child is otherwise unstable. We almost exclusively use pig tail drains at this point. In our opinion they are also more comfortable for the infant and they are placed easily. Our surgical patients though often have straight tubes.
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What does your DART look like?
Hi we use the DART scheme as published and rarely change it. For select patients we have done a second round with precisely the same regimen after a couple of days in between. FC
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Medical simulation applications
This app might also be helpful in simulating monitors - it is free to download from the AAP (American Academy of Pediatrics) and available on OS, Android and PC https://play.google.com/store/apps/details?id=com.aap.vitals&hl=en&gl=US
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Anakimra Protocol
Here is a citation that might help: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4103976/ They used high dose with 9mg/kg - compared to standard dosing 1-2mg/kg for severe neonatal Kawasaki. May I ask in what clinical setting you are thinking about using it?
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Monivent keeps supporting 99nicu
Very much appreciated.
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Ranks! (or how to become a Grand Master)
Grand master - that sounds just about right for you, Stefan 😉
- Using ultrasound for lumbar puncture in preterm infants
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Car seat challenge
I wonder what the share of babies going home in cars is in different countries.. Might this have an effect? I will add this survey from the US where >96% of NICUs perform a predischarge car seat tolerance screen (CSTS). https://pubmed.ncbi.nlm.nih.gov/32044465/ Does it help at all? In any case it seems to prolong the stay if an infant fails the screening test. https://pubmed.ncbi.nlm.nih.gov/29269198/