JACK

Neonatal falls is an event which should never occur in any hospital. Though most of us presume that neonatal falls can never happen but unfortunately they do happen. LINK http://pediatrics.aappublications.org/content/122/2/e277.full.pdf+html There is a very nice article discussing this issue and making recommendations to prevent neonatal falls. I found this article very informative. LINK http://downloads.hindawi.com/journals/ijped/2010/547528.pdf Have you had a neonatal fall in your hospital? Could you share the circumstances of the fall.

While helping my nursing colleagues to revise their NICU nursing competency checklists , I came across the following: LINK - 1 LINK - 2 We found these very informative

Just wanted to inform the members, that the 9th edition of "Antithrombotic Therapy in Neonates and Children: Antithrombotic Therapy and Prevention of Thrombosis" from American College of Chest Physicians is out. Link

This is a nice document available online: www.luhs.org/depts/emsc/NICU_evac_guidelines.pdf

Being prepared for disasters is of paramount importance. I am sure all NICUs have some sort of drills / evacuation (horizontal and vertical), etc on a regular basis. I want to know how you are preparing your units/staff for an emergency. What equipments do have for evacuation? What plans have you made? What contingency plans have you made? Have you done a full evacuation drill? In case of a real emergency will you be able to evacuate all your patients in a timely manner? Do you use evacuation vests( Vests with pockets for keeping babies !) ? Have you faced a real emergency in your NICU? How was your experience?

the nrp dvd is very good...i would strongly recommend it

As per Neofax 1 mL MCT oil provides 7.7 Cal

http://ebookbrowse.com/bolisetty-2006-preterm-outcome-table-very-preterm-infants-pdf-d229709866

The biggest problem facing a neonatologist while counselling propspective parents of an extremem preterm during intrapartum and immediate post-natal period is getting the parents to comprehend the whole picture - the mortality, the morbidity. I think if we all start using a POT (Preterm Outcome Table) made from our local hospital data, then it may help parents understand what they are facing. This may help in counseling and helping parents make an informed decisions. LINK: http://www.ncbi.nlm.nih.gov/pubmed/16704470 Can also develop computer based tools like the one from NICHD data to better communicate mortality/morbidity data. The stress should always be on local experiences instead of conveying some international figures which will not be achievable with the given resources and expertise in that hospital LIN: http://www.nichd.nih.gov/about/org/cdbpm/pp/prog_epbo/epbo_case.cfm

This should answer your questions http://www.llli.org/faq/milkstorage.html

You may find there helpful: http://www.ncbi.nlm.nih.gov/pubmed/6835716 http://www.ncbi.nlm.nih.gov/pubmed/3694347

I have to totally agree with this comment. Also as we see iPADs make there way into airplane cockpits, I feel that there may not be anything to worry about iPADs in the NICU. If planes can stay in air with an iPAD in the cockpit, I am sure the ventilators and monitors in the NICU can continue to work. ...though I am no Radiofrequency expert but we really need specific interference data before we put a blanket ban on all smartphones and tablet devices. Like mentioned by nbenfadel....iPAD is a boon to doctors, nurses and ultimately improves patient care LINK: http://www.popsci.com/technology/article/2012-02/air-force-buying-ipads-replace-flight-bags LINK: http://news.cnet.com/8301-13772_3-57342524-52/faa-gives-nod-to-ipads-in-cockpits-for-american-airlines/ At the same time dont forget the article referenced here http://www.99nicu.org/forum/showthread.php?24185-Iphone-Interference-with-ECG

This should sum it up for you http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3261088/?tool=pubmed

How do you ensure that iatrogenic burns are avoided ? Any specific temperature for the water ? How long will you keep the 'warm water filled glove' in contact with skin? Have you had any cases of iatrogenic burns ?

Avery's Diseases of Childhood has to be the one I would recommend...it is exhaustive , covers all topics....

May I also invite our members who have pulse oximetry screening at their hospital to kindly share their experiences (successes/failures) with us.

If you you want to increase calorie density, there are some who add MCT (medium chain triglyceride) oil. MCT oil is available but costly. So one very cheap and effective alternative is to use purified/refined coconut oil. Coconut oil contains mainly MCT .

We never use muscle relaxants in ventilated cases except in Meconium Aspiration cases on HFOV where we have difficulty maintaining oxygenation....but that too for a short duration and as a last resort....

I think the point to be considered here is the safety of the work environment. Safety with regards to: -Infectious diseases -Radiation Safety -Chemical hazards (including Nitric Oxide) -Physical stress -Working hours -Ergonomics of working conditions (including chairs/desks/etc) A NICU should ensure that all personnel (doctors and nurses) working in it are safe from all of these risks at all times. If the work environment is safe then it doesn't matter much whether the nurse is pregnant or not. The two circumstances where pregnant nurses are given special considerations are: - Exemption from interfacility transfers - Sometimes as per personal request exemption from night shift Other than these two "special treatment" , I believe the NICU environment and work conditions should be so safe that it does not make a difference whether you are pregnant or not. The environment and working conditions are so safe, that you are never at risk.

No personal experience but here are some useful links: 1- Google books 2- http://pediatrics.aappublications.org/content/92/1/86 Other related treatments: -Metallopophyrins -Charcoal

Related: http://www.neonatologyresearch.com/?page_id=1694

Not exactly to the point but very informative http://www.adhb.govt.nz/newborn/guidelines/vascularcatheters/UmbilicalCatheters.htm

We all know that NICU care does not come cheap. So I want to know how your patients tend to pay the bills. Are you faced with ethical dilemmas when financial limitations limit care ? As for my NICU, the government pays for the NICU care of all its citizens. The non-citizens are of two types. The insured and the non-insured. The insured have no problem. The non-insured have lot of problem paying the bills...but the hospitals here work with many charitable institutions to foot the bill.

Have you seen any adverse events ?

Stefan...did you mean "Spectrophotometric Analysis of Cerebrospinal Fluid" ? (http://www.clinchem.org/cgi/reprint/54/11/1924.pdf)