Vicky Payne

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?

Great idea! I have also added the free online ESPR/NOTE guest lectures to the calendar 🙂

A series of free, online guest lectures in pulmonology, courtesy of the NOTE and ESPR collaboration. I have added these dates into the calendar, but you can sign up for these by contacting noteteam20@gmail.com. All times are in CEST.

Hmmm, I am not sure I know of any specific drugs where PICC line delivery is contraindicated- however, there are sometimes concerns with certain drugs mixing/being incompatible with other drugs going down the same PICC line..... is that what you mean?

There has been a lot of thoughts on this in the neonatal Twitter community! is intubation a mandatory competency for trainees in your country? Should it be? How do you as a neonatal physician/ANNP/NNP keep your skills up to date? How many is “enough” to be deemed proficient? 🤔🧐🤓

Also there are papers now looking at "cooling outside criteria" which are interesting too e.g. late preterms, stroke..... This RCT was in adults but suggests worse outcomes in adults undergoing therapeutic hypothermia who have bacterial meningitis.....https://pubmed.ncbi.nlm.nih.gov/24105303/ A neonatal study (Jenkins et al 2013) has looked at immunosuppressive impact of cooling. Newer possibilities: cooling in NEC?!? https://pediatrics.aappublications.org/content/125/2/e300.short and lots of work now looking at adjunctive therapies like xenon and erythropoetin..... And perhaps a topic for a separate discussion thread....and I think topical to practice (in UK) cooling in mild HIE?!? https://fn.bmj.com/content/105/2/225.abstract?casa_token=urlRBLGeNVgAAAAA:mpPfBX_gPwzVlNLIpUYO9ETpCgdI20zJNzxhuJ2EoqU-hcqW3NGeoqpYXAH9GN-6fZrhsSx-mRk

I have only come across this thread too! We (UK) have 48 hour hang times for vamin, and 24 hour lipid change. The lipids are infused on a separate syringe driver, and the vamin run through different fluid pump. We were looking into using orange light protecting giving sets for the lipid which a different colour to our standard giving sets for bags of fluid. We have standard manufactured bags of PN in stock on the unit, and then we can also get special bespoke bags made via our aseptic pharmacy team if the patient needs fluid restriction or careful electrolyte management. Our nurses change the fluids using aseptic non touch technique. I think the point about accessing lines less frequently is a good one @Chris van den Akker.

Do you think the evidence provided in this paper would change your practice @Francesco Cardona? @bimalc makes a good point about parent choice and options- has anyone asked them (parents) what impact this might have on them?

I am really excited to see what the @99nicu.orgcommunity makes of this paper, and look forward to hearing everyone's comments! Lets start a conversation and share examples of practice, or what we might think future practice should look like 😍

Useful resources on managing a difficult airway developed from the British Association of Perinatal Medicine....practical flow charts and equipment to have to hand! https://www.bapm.org/resources/199-managing-the-difficult-airway-in-the-neonate

We do not currently use any heated humidified air in the delivery room.....we do this once we get back to NICU. I would be interested to hear what others do?