Stefan Johansson

Thanks for posting! Please also post in the Calender http://99nicu.org/calendar/ (I assist you if you need help, drop me a PM if so)

@marycam - wished I could share something with you in English, but I googled and found two good lectures (slides as PDF) and one document from somewhere in the UK https://www2.aap.org/sections/perinatal/PDF/PerinatalWorkshop2010/DunnGolden.pdf http://angels.uams.edu/files/2013/10/Neonatal-Golden-Hour.pdf https://www.networks.nhs.uk/nhs-networks/staffordshire-shropshire-and-black-country-newborn/documents/golden hour 2011-13.pdf If anyone has a clinical protocol that could be shared - please do!

Have you explored what are the differences compared to the previous version?

@Martin.Keszler - you're right about small preterms. Our masks are designed for infants 2000 grams and up, but it has been said that a tiny mask will be around, allowing use down to 800 grams. I work in a level2-unit right now and we care for babies from 28w and up, so a smaller device would be great. When infants <31w are delivered we have a neonatologist on site though, and if needed these babies are intubated. But for unexpected near-term/term infants, and when fellows are at the front line, they commonly use laryngeal masks if they are uncomfortable with intubation.

@vito62 - does this mean that you need to do less plain X-rays. If yes, have you estimated how many less x-ray investigations you need?

I switched hospital ~2 years ago and even if our resuscitation tables are equipped exactly the same as in the previous hospital, I have noticed that fellows here use laryngeal masks more often during resuscitation, instead of going directly from mask (+NeoPuff ventilation) to intubation. I must say that my experience has grown very positive, laryngeal masks can be applied with little training and gives good airway support. EBNEO has published a review here : https://ebneo.org/2015/09/airway-support-during-neonatal-resuscitation-how-effective-is-a-laryngeal-mask/ on a RCT on this specific question, laryngeal mask vs face-mask-ventilation. I fully agree with the conclusion that: Do you have similar or other experiences to share?

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In the NICU we change every ~3 hours, and use alternate between hand/foot on both sides.

@safaa5@hotmail.com and @Melanie - the link to the PDF had changed as a result of the IT work last week, I have corrected it know, and download works

@alyelayyat Have a look at this video: http://www.neoknowledge.org/chest-tube-pigtail/ Regarding knowing when you enter the pleural space - you'll feel it As you insert the tube rather high on the chest you will be certain that the tube is in the pleural cavity when you insert it, the "reciept" will be that you can aspirate air.

We use chlorhexidine (5 mg/ml with alcohol) for infants >1500 gram. In practical terms, that means infants ≥32 weeks.For very preterm infants (<32 weeks) we use chlorhexidine solution (2 mg/ml without alcohol).

I am waiting to board the flight from Stockholm to Philadelphia, to attend the 3rd Evidence-Based Neonatology (EBNEO) conference. Although being biased (as part of the organizing committee), I think the meeting will be great! You can follow the meeting on www.ebneo.org, on the hashtag #ebneo2015 And, I think the EBNEO Society, the principal organizer of the conference, has an important mission: to increase the knowledge about evidence-based neonatology, and how to apply its principals in neonatal medicine. That also includes understanding of the pitfalls, that "evidence" is not binary, and that we can and need to do much more research and development to further improve care. I recently wrote a column about diagnostic testing in the Swedish Medical Journal (Swe. Läkartidningen). http://lakartidningen.se/Opinion/Reflexion/2015/09/Simtur-i-diagnostikens-djupa-vatten/#comments I got a comment in English implying that EBM is in conflict with the old-school notion of being a good doctor. That is not the case, def not in neonatal medicine where the caring for babies and families, from a humanistic point of view is central in our daily practise.

@JACK - I guess we only track this for WHO... as the doc is not on our server But the bit.ly-service is nice - please study and get back

The WHO has published international recommendations to improve the outcomes of preterm birth. I got to know about this document about a year ago while attending a Preterm Epidemology working group meeting hosted by the WHO. Given the fact that preterm birth is the most important risk factor for infant mortality world-wide, I think this document will be very important, especially for preterm babies born in low-resource settings. Read the commentary in Lancet here: http://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)00183-7/fulltext Find the WHO publication here: http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/preterm-birth-guideline/en/

Hello! I would suggest to wait, at least for a few weeks. The cases I have come across have resolved spontaneously (but must admit that my experience is limited...) This paper/case report http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3611918/ suggests that plication of the diaphragm can be indicated around 1 month of age.