Hamed last won the day on August 30 2019
Hamed had the most liked content!
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70 ExcellentAbout Hamed
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Rank
Member
Profile Information
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First name
Mohamed
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Last name
Hamed
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Gender
Male
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Occupation
Assistant professor of Neonatology
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Affiliation
NICU
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Location
Japan
Recent Profile Visitors
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Any advice for diagnosis and management of case with Bronchopleural fistula? (and if the Bronchopleural fistula was in case of ChILD would your management differ)?
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Are masks mandatory in your NICU during coronavirus pandemic?
Hamed replied to HickOnACrick's topic in infections
Here the government officially recommended using any type of masks a starting from 1st week of April. As for health workers, hospitals recommending using surgical masks a couple of weeks earlier, and for workers to limit the number of masks they use/day. This week putting on surgical masks in hospitals was strengthen. N95 masks and other PPEs are only to be used in our NICU if a "confirmed" COVID-19 infected mother was to give birth, which we still didn't experience, and their use are limited to the NICU members who resuscitate this newborn. -
Nebulized racemic epinephrine for extubation of newborn infants
Hamed replied to Pototo's topic in practical procedures
Only when showing post-extubation stridor agree with @bimalc Although, @Pototo I would like to know did you mean Racemic epinephrine (before or after extubation)? -
@Lenks I do agree with @bimalc, as many of these cases are transient and seem to resolve spontaneously without any specific treatment. In case high Ca intake is suspected to be the cause of hypercalcemia, discontinuing powdered human milk fortifier or preterm formula to first stop this extra intake and closely monitor serum calcium levels without immediate further evaluation. Additionally consider temporarily discontinuing vitamin D supplementation if providing. In case spontaneous correction of serum Ca doesn't take place further invitations as mentioned above with adding renal ultrasound w
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Umbilical venous Cather in full term infant 2days old
Hamed replied to Dr.Smah's topic in practical procedures
Routinely, we would confirm umbilical lines with a cross table lateral view additionally to the AP view. Although, in the X-ray kindly presented here I do agree with @bimalc the UVC is mal-positioned and no need for a later view. This UVC could be pulled back to be 2 cm below the level of the base of the umbilical stump = (2 cm + length of the umbilical stump) and be used as a low line = (as a peripheral line) /Or if still a central line is indicated a PICC could be placed. I would revise the need of a central line in this infant. In the scenario if this infant was just being resuscita -
Respiratory distress in neonates of smoker mothers
Hamed replied to Dr.Smah's topic in pulmonary disorders
Same here in Japan, as well as in our unit in Canada, no special management for preterm infants of smoking mothers. Although we have a concern towards smoker parents when they visit their babies in the NICU, we do ask them not to smoke before coming to the NICU and to wear newly washed cloth which doesn't have smoking smell in them. -
@Lenks Concerning hypercalcemia (total Calcium of 12 mg/dL is our cutoff for IV saline 10-20 ml/kg with 1 mg/kg lasix. A persistent hypercalcemia in-spite the lasix and total Calcium above 14 mg/dL we would consider glucocorticoids. No experience with bisphosphonates. Calcium intake should be thoroughly reviewed. Although day 7 is early for subcutaneous fat necrosis to cause hypercalcemia, but checking for sites of it could be advised, Further lab. data to know the etiology: ionized calcium, pH, albumin, phosphorus, alkaline phosphatase, PTH, urine sample for spot calcium/creatinine ra
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Joseph Aldric started following Hamed
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Wireless sensors for neonates to encourage Kangaroo Care
Hamed replied to AntonioPCam's topic in nursing the neonate
@AntonioPCam thanks a lot, I think contactless monitoring would really be helpful in the NICU. Wishing you all the best.- 1 reply
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- kangaroo care
- kc
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therapeutic hypothermia - do you ventilate just for cooling?
Hamed replied to Schumz's topic in hematology
Concerning the need for intubation and Mech. vent. I concord with @bimalc, @Stefan Johansson and @rehman_naveed and once in during cooling it will remain in until the end of cooling or until an MRI is taken at 4~5 days of life. As for comfort, we do as @rehman_naveed, we give low dose morphine infusion 5 mcg/kg/h not exceeding 10 mcg/kg/h or fentanyl 0.5 mcg/kg/h not exceeding 1 mcg/kg/h (fentanyl preferable for hemodynamic compromised infants). Coming to the timing of MRI, it may vary according to each hospital`s protocol. In addition, it really depends on what you want to see, diff -
Where to measure hemoglobin and hematocrit
Hamed replied to Andrej Vitushka's topic in fluid and electrolyte balance
Hi @Andrej Vitushka thank you for your question and discussion, it opened up a lot of thoughts. Sorry for seeing your question so late, @Stefan Johansson kindly answered. Thanks Stefan.- 9 replies
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- anemia
- hemoglobin
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Where to measure hemoglobin and hematocrit
Hamed replied to Andrej Vitushka's topic in fluid and electrolyte balance
Hi @Andrej Vitushka you can use both central or capillary. For cutoffs please check the PINT study. We use table 1 low threshold cutoffs for transfusion. https://www.ncbi.nlm.nih.gov/pubmed/16939737 PINT trial.pdf- 9 replies
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- anemia
- hemoglobin
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Unfortunately, not using LMAs in our Perinatal-neonatal center.
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@NICU RN 7 thanks, could you please clarify this sentence " clean skin with chlorhexidine 2% without" ?
- 16 replies
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- temperature management
- antiseptic
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Yes, please check my writings above @M C Fadous Khalife if you have further concerns, I would be happy to help out.
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Next 99nicu meetup coming up in 2019!
Hamed replied to Francesco Cardona's topic in Congresses and courses
Copenhagen