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99nicu.org 99nicu.org
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ali last won the day on June 11

ali had the most liked content!

About ali

  • Birthday 07/04/1968

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    Trainee Advanced Neonatal Nurse Practitioner
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  1. Hello Everyone, A shout out to any Units that utilise a Neuro Care Bundle for your extreme premmies and/or HIE. Would you be kind enough to share or send me a PM on your approach please? Many thanks Alistair
  2. Hi Everyone, Given the infants remain servo controlled in either jacket or mattress and central lines can be visualised (provided no coagulopathy) it seems extremely harsh to ask a parent to not be able to hold their child for almost four days (if you include rewarm period). A study into aEEG response to cuddles might reveal some interesting results?? https://pubmed.ncbi.nlm.nih.gov/30721531/
  3. @Andrej Vitushka, @Vicky Payne, Hi, we don't have NIRS, but there is clearly a growing interest in it's validity and use in HIE & TH (neurodevelopmental prognostication) and end organ perfusion in the face of a HsPDA. One of our Consultants is keen to examine it's use on the Unit. We have gone full circle and use Transcutaneous monitoring on most of our babies, including Transport, it had gone out of favour (for no valid reason) in the face of EtCO2 capnography. I am sure the circle will turn again🙄. Kind regards Alistair
  4. Hi 99ers, Although as a Unit we have an extubation guideline that needs to be observed prior to extubation I am intrigued to know if a guideline or list of interventions attempted (increase of CPAP pressure, maximum FiO2 requirement, CO2, permissive hypercarbia) before the decision is made to reintubate. Many thanks for your thought and opinions. Please all stay safe. Best wishes Al
  5. Many thanks for the link. Kind regards Al 🤗
  6. Hi Bimalc, I have messaged you. Thanks Alistair
  7. Hello 99Nicu, Recently we have had a number of infants who have required IV Dextrose infusions following episodes of low sugars. Does anyone know of or use a specific guideline when reintroducing, regrading back onto enteral feeds and the monitoring of blood sugars? Many thanks Stay Safe Alistair
  8. Hi bimalc, regarding your BPD, what do you feel your Unit is doing that produces such good outcomes, cos where I work we are outliers and I am trying to identify where our practice could improve? Thanks Alistair
  9. Hi 99ers, May I plant a hypothetical scenario to prompt a discussion around the number of steroid courses (DART/Durand etc) to promote extubation. An ex 23 weeker, now 6 weeks old, extubated onto FDCPAP (FiO2 0.7) following second DART regime, but O2 now climbing and now consistently > 0.9 (3 days post end of previous DART). Gaining weight, Diuretics, Ureaplasma -ve, Azithromycin trialled, compensated gases and evolving PIE. Would you reduce your saturation limits and tolerate the high FiO2 requirement, commence a third course of steroid prior to intubation, intubate and then start a 3rd course. Would you ever consider a fourth trial of steroids? Thank you in advance Alistair
  10. Hi Everyone, Is anyone from the forum able to throw some light on the possible rationale for a CFM trace that when the infant displayed subtle electrical seizure activity on the raw eeg the baseline dropped instead of displaying the classical uptick in the baseline? I have never encountered this phenomenon before. (all the probes were in the correct position and correctly connected to the monitor) Thanks, stay safe Kind regards Al
  11. Hi 99ers, Do any of you have personal recommends of influential books/articles when it comes to effective clinical decision making, as I am finding myself taking on more of a senior role upon the Unit where I work. Thank you everyone. Keep safe, keep your distance. Alistair
  12. Hello everyone, Just undertakiing an audit of unplanned extubations on our NICU. As a matter of interest is anyone aware of the use of a risk assessment tool to ensure avoiding unplanned extubations? Thanks Alistair
  13. Hi 99ers, I am intending to formalise a teaching package for cUSS for both junior medical colleagues as well as our cohort of Nurse Practitioners, so was intrigued as to whether any members already have a teaching in place and how it looks with regard to theoretical/practical teaching and assessment? Many thanks Alistair
  14. Hi 99ers, Conversely may I enquire whether any members have encountered the scenario of a premmie who has successfully reached full enteral feeds but remains hyperglycaemic with blood sugars consistently over 13/14 ? What further investigations may be revealing? Thank you in advance Alistair
  15. Hi 99ers, I am interested in what format you gain parental feedback following a transfer by your transport service - is it paper and postal or electronic etc or something else? Thanks in advance Alistair
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