Zuzana Tomaskova

This is from BLS and if there is only one rescuer in peds. Not recommend for advanced resus in neonates.

Depends whether you use NRP or PALS. NRP coordination 3:1 even in intubated pts PALS once intubated there is no coordination But I prefer NRP for any neonate not PALS - it is proven that it's more effective.

In Czech Republic we do prepare it bedside or in our hood in the unit. In Saudi we received it fron the pharmacy and connected tubing bedside (for CVL or PICC or UVC as sterile procedure). I do believe if you prepare it correctly bedside (clean environment, equipment, proper technique) theb you are safe but you have to know that your staff adhere to correct procedures which is sometimes very hard... But this is my opinion nothing from EBM.

Dear All, I would like to seek your help. I remember I read about differences between Fentanyl and Morphine action during cooling protocol in our NICU patients. Unfortunately, I cannot find the evidence now (may be I am looking wrong) whether Fentanyl or Morphine is better option. Both are metabolised slower during cooling and we have to be careful in administration. My knowledge is that Morphine was drug of choice due to better binding to pain receptors and a bit better action during cooling. I remember some article (from Pediatrics, Neoreview?) and there was mentioned even some protective effect of Morphine. Can you help me with sources or whether it is still true? I know that now Clonidine is being studied as possible neuroprotective drug too but nothing specific about mentioned meds above. Thank you very much Zuzana

My opinion for insertion definitely yes. It is invasive entry and we work with sterile items. To prevent CLABSI anytime you work with any CVL or PICC in open form (insertion, dressing, set changing) you should be in full PPE because you are opening sterile consumables and instruments. Cap and mask protect area from contamination by hair fall or any droplet cobtamination. Many times I was witness of the doctor's and nurse's groups talking above sterile table during insertion or line changing and I think it is big risk to remove mask for sure. Cap I can may be think about. We always have to think that our little patients are fragile and we have to rise our precautions up compared to other units with older patients.