Vicky Payne

In our unit we categorise our babies into high-risk, medium-risk and low-risk for nutritional management of PN and enteral feeding. High risk, severe IUGR with absent or reversed EDF babies would be 10-20mls/kg/day. We also have guidance about how to manage abdominal distension and aspirates- but there is a definite movement in the research community around stopping "routine" checking of gastric residuals....

Good question re: LOS! I think we probably still would i.e if clinical suspicion was low with negative laboratory parameters e.g. WCC and CRP (though more like 48 hours than 36 perhaps...), but if laboratory parameters are concerning, maybe 5 days with a negative culture...... And I also like the Cantey commentary- nice share! There is some suggestion that prolonged duration of EOS antibiotics for 'culture negative sepsis' in preterms is associated with increased risk of LOS... https://www.tandfonline.com/doi/full/10.1080/14767058.2018.1481042?casa_token=Opk-yk6TMrgAAAAA%3AzNoO9exu3ovIVBe20ZfN2HXJyPVMhVyT_TiY_J7edvdc-cjBIED-COC5Lu-GyhcRzIvVU8jnYt0

Webinar on the role of the neonatal behaviour assessment scale (NBAS) and newborn behavioural observations (NBO) in the neonatal unit. See more information here: https://nna.org.uk/events/

Calling all nurses on the NICU! Please see below for opportunities to apply for travel/education/research scholarships! https://nna.org.uk/scholarship/?fbclid=IwAR2tbRBT4yV7O8E3U7RwF3_kBAmqJnxSHIHvQ7SbPMW5UXlQSbBSYtSI93g

Check out this new podcast from ADC with the authors of the above paper (and others!) related to LMA airway management! This links really nicely to the above webinar ran earlier in the year!

What lovely feedback from the parents. Perhaps you could share more about the ABC3 study please? I am sure lots of people would be interested to hear about it!

This might be useful to some, covers paediatrics and some neonates. "Waiting until 48 hours to stop antibiotic therapy in all children is an outdated approach. Research shows that 90% of bacteria will have grown by 24 hours and 95% by 36 hours. In children with low BSI suspicion, stopping antibiotics at 24–36 hours with good safety-netting advice avoids unnecessary hospitalisation without jeopardising patient safety" https://ep.bmj.com/content/edpract/106/4/244.full.pdf Just for fun.......anyone stopping at 24 hours?

We do- not for all babies, but we also include late preterms on transitional care- I will tag our neonatal home team/community team to the post on Twitter (Hayley) and hopefully she can help you!

Thanks for sharing! Looks like plenty of tips to improve the transport experience for families!

Saw this and thought of this thread!! Might be worth trying to link up with the researchers about this!

I know an ANNP who is looking at this for her dissertation- I can send on your contact details if you like?

Hmmm, not in my unit (UK). Will be very interested to see what other units do.... but we also don't get babies out for cuddles with umbilical lines in either, and most of our babies having therapeutic hypothermia would have umbilical lines in too. Looking forward to seeing others responses....

We mostly take blood gases, but if using other methods it tends to be capnography. We have trialled some transcutaneous CO2 recently that appeared to be quite good for monitoring trends without the skin burns that were seen in the past. Personally I think alternative methods like capnography or tcm for measuring CO2 are underutilised, and would be useful for monitoring trends.

Thanks @Andrej Vitushka! At our NICU, EtCO2 is not used routinely on all babies- we use it on a case-by-case basis, and during surgery/transport. We do not use NIRS yet. Other UK NICUs may have a different experience and may use it more frequently.... @ali?