AlexScrivens

I’ve used both - both work with reasonably good technique. I loved the tenderheel ones when I first started neonates (and I was crap at heelpricks then!) our hospital then switched to the unistix which are made for adult finger pricks I think, and they were awful so we used to all have secret stashes of the tenderheel ones stolen from various other departments!

My logic suggests that if the placenta has separated for a period of time or baby has bled into the mother, then DCC may be of limited benefit... (but happy to be proved wrong!) I think the practical difficulty is that we do a lot of sections for 'suspected abruption', where baby comes out ok, in which case I usually do DCC unless baby looks really grim (scientific term) at birth.

I don't know anyone who intentionally sets out to cool babies with mild HIE, but I think there is a degree of therapeutic creep which means that we are probably cooling more babies now than we did a few years ago. The COMET feasibility study is looking at no cooling v 24 hrs cooling v 48 hrs cooling v 72 hours cooling in mild HIE. Their protocol is here: COMET

i agree, would not necessarily ventilate a baby just for cooling - unless maybe they were particularly agitated, had PPHN or other problem Controversially, I don't see a problem with extubating during cooling, particularly if baby breathing spontaneously or struggling with overventilation. Anyone fancy pooling some data and comparing practices in different places?