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tarek

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Blog Comments posted by tarek


  1. Its importance will come when you will face a baby when you can not hear His Heart sounds like Hydrops babies

    I wittnessed chest compression start to one hydrops baby as no hear beat detected by auscultation and after PPV

    I am with ECG leads and monitor to be available in perfect setup

    Using ECG leads accirding to NRP guidlines should be implemented from january 2017

    Tell now we are trying to make it available in OR and LR

    How should you assess the baby’s heart rate response during compressions?

    Briefly pause compressions and, if necessary, pause ventilation.

    An electronic cardiac (ECG) monitor is the preferred method for assessing heart rate during chest compressions. You may assess the baby’s heart rate by listening with a stethoscope or using a pulse oximeter. There are limitations to each of these methods.

    •During resuscitation,auscultation can be difficult,prolonging the interruption in compressions and potentially giving inaccurate results.

    •If the baby’s perfusion is very poor,a pulse oximeter may not reliably detect the baby’s pulse.

    •An electroniccardiac(ECG) monitor displays the heart’s electrical activity and may shorten the interruption in compressions, but slow electrical activity may be present without the heart pumping blood (“pulseless electrical activity”).  In the newborn, pulseless electrical activity is treated the same as an absent pulse (asystole).

    Copied from textbook of neonatal resusscitation 7th edition


  2. In the past there was time that we are not giving feed to babies with uvc&uac till we remove them it was making sense at that time and this practice changed.

    The practice of stopping feeding during transfusion will change .

    I think that the babies who recieved PRBCS are sicker than others thats why they have more incidence for NEC if proved same like the incidence of mortality is higher in patients recieved platelets transfusion because definitely they are sickers than others

     


  3. Thank you for the very practical question that we are facing in every day practice

    For last couple of days i had this list neonate with hemoglobin 9.8 shifted for coarctation repair we resreved blood for him and shifted to the surgical centre

    Another one initially with gastroschiesis jeujonostomy and ileostomy done for him and went to OR for stoma closure his Hb was 8 we gave him PRBCs before OR

    Hydrocephalus for VP shunt shifted to OR with Hb 13

    Fresh newborn D2 MMC repair 

    Sooooooo

    I agree with you some babies need to be transfused before OR specially we do not know how much of blood they will lose during OR

    Really i like this topic we need a clear guidline for that

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