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Everything posted by Francesco Cardona
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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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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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Antibiotic choice in 22 week babies
Francesco Cardona replied to dramitkan's topic in Medication & Pharmacology
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 -
Done
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Transport Issues
Francesco Cardona replied to Francesco Cardona's topic in Support NICUs in Ukraine's Discussions
Irish colleagues airlifted Ukrainian patient to Ireland. https://twitter.com/transport_neo/status/1505611005312831494?s=20&t=fP2I3GwnBeaK60jwfwvomA- 1 reply
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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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I can offer help!
Francesco Cardona replied to piatkat's topic in Support NICUs in Ukraine's Discussions
What is the best way to contact travel nurses best? -
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
Francesco Cardona commented on Stefan Johansson's article in 99nicu News
Excellent! -
Family-center care - a 99nicu webinar series
Francesco Cardona commented on Stefan Johansson's article in 99nicu News
It says Webinar 1 on both 🤔 -
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?
Francesco Cardona replied to ali's topic in Medication & Pharmacology
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 -
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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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
Francesco Cardona commented on Stefan Johansson's article in 99nicu News
Very much appreciated. -
Ranks! (or how to become a Grand Master)
Francesco Cardona commented on Stefan Johansson's article in 99nicu News
Grand master - that sounds just about right for you, Stefan 😉 -
Car seat challenge
Francesco Cardona replied to dramitkan's topic in Neonatal Nursing & Family-Centered Care
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/