JACK

Back to basics...Penicillin

Thank you for the excellent resource. Very helpful.

Dear colleagues, I wanted to know what your local practices are in cleaning the cranial sonogram probe(transducer) between patients? Cranial sonograms are a routine procedure in all NICUs and I was wondering if there is an infection transmission risk while using the probe on multiple patients without cleaning the probe between procedures.

A detailed history (antenatal, delivery, resuscitation) Examination findings Neuroimaging The point that the baby took time to establish breastfeeding is to be noted. Was it because of mother-baby interaction problem or was it due to poor suck or poor suck-swallow coordination?

You will find these very helpful http://www.maryrutherfordimaging.co.uk/presentations.php

Thanks for the info...Looks good

Actually whether you use a costly readymade company provided Bubble CPAP apparatus or make a cheap homemade CPAP device - doesn't matter ...the end result is the same for the patient. However I would stress on choosing the correct nasal prongs to go along with any cpap device. I have seen some nasal prongs which damage the nasal septum. And one of the most important investment needed for the success of CPAP in any unit, is training of the nursing staff who will take care of the baby on CPAP....CPAP will fail in every case without proper nursing support !!!

The question to answer is --- What are you expecting from the machine? Do you just want pH, PCO2 ? Are do you also want MetHb? --- this is very important if you use inhaled Nitric Oxide in your unit Also do you want Hb , electrolytes ? The most important is how is the after sales maintenance and availability of the buffer solutions//calibrating gases/ cleaning solutions? I would not recommend any single company, because that would be biased. All the ones out there, with quality accreditation and international presence have excellent products. The product which you will buy will be based on your requirements, the ease of use and maintenance. It is also a good practice to inquire with your colleagues in hospitals nearby to their experience with their blood gas machines and any complaints that they have. Some companies have excellent after sales service in some areas but weak in others. As blood gas machines require constant servicing and constant care, I strongly recommend a company which has a strong presence in your area and also has a good reputation in your locality. Hope that helps !

Are the drugs that we use for sedation / analgesia in neonates really safe ? Do these drugs themselves have any deleterious effects (long term neurodevelopmental) ?

Check this link : http://www.nemo-europe.com/

http://fn.bmj.com/content/88/4/F345.full

In the 99nicu run subreddit "/r/neonatology", a pediatrician has a query regarding sub-specializing in Neonatology LINK:http://www.reddit.com/r/neonatology/comments/101m94/subspecialty_in_neonatologyin_need_of_advice/ If anyone has anything to contribute kindlt post below and it will be crossposted to reddit Thank you

Is anyone using winrop ( https://winrop.com/ ) ? REF: http://pediatrics.aappublications.org/content/123/4/e638.full.pdf#page=1&view=FitH

We are doing our Laser Retinal Photocoagulation in our NICU in a pre-designed area. I just wanted to know where other NICUs are doing their Laser therapies? (NIICU or OR) DO you have a special area marked for Laser? If doing Laser in NICU how do yo manage to comply with Laser safety regullations? How do you ensure safety of other staff in NICU during the laser?

Thanks for the info Ruth

Thanks Stefan for the info

A user in our 99nicu moderated subreddit "neonatology" asked the following: Link to original discussion

Cross Post from Reddit:

Cross-Post from Reddit

Cross-Post from Reddit

For pulmonary hemorrhage, we go for a high Peep strategy on conventional ventilator. Try to maintain hemodynamic stability. Try to see what is the cause (?DIC , ? PDA). Do NOT overtransfuse packed RBCs when you see Pulmonary Hemorrhage. We have very good experience with activated Factor 7 (Novoseven) in controlling pulmonary hemorrhage.

We are calculating what is the NICU bed requirement for a region. Instead of an arbitrary number, we decided to actually derive this number through scientific calculations. So given a region with a population Y (Eg. Y= 1 million people) with a fertility rate of X live births per 1000, what would be the NICU bed requirement for that region? Of that how many would be NICU-Intensive care beds and how many NICU-Intermediate care beds? I know it seems very hypothetical, but this is an actual problem we are facing and we will submit this to the appropriate authorities to justify our needs. I feel that with a proper scientifically derived requirement, it will be easier to get the help from the administration rather than based on arbitrary numbers.

We use this(LINK) installed in a separate computer in NICU (separated from the main hospital IT network) connected via dedicated network to this (LINK) in the IV room in the Pharmacy. The TPN instructions are entered into the Abacus software in NICU by the NICU doctor along with pharamacist (who comes and stays in the NICU during the TPN entry). The pharmacist is a boon as she often recognizes problems in the TPN order very early (like when calcium precipitation is very likely, etc).

Thanks Christian...I edited the post

I will post here a post from the subreddit of neonatology. Awaiting your replies. Will cross-post answers from here to the reddit forum. Original Post in Reddit - LINK: http://www.reddit.com/r/neonatology/comments/yo9bd/hey_all_i_have_a_few_questions_about_being_a/