johan john

How do u guys perform eye lid closure effectively in neonates to prevent exposure kerotopathy .any special aids?

How often do u suction your micros, one of the MD'S were not satisfied with me when Itold Ididn't suction my babe for the last 8hrs. actually babe was doing well and vent parameters went down as well. Do any one of u have any literature suggesting not to suction micros aggressively.for me Idon't like to touch them unless indicated.

This happened on new year night in our unit. A case of peri asphyxia hypotonic hypoactive babe was placed on the seca scale for weighing after sponge. the nurse applied oil on her during bath. the babe kicked his leg and slided off from the scale on to the floor. the babe had no external injury. xrays , head uss ,cbc bga, and ct normal. incidental report was completed. now Idont know what will be the further proceedings? Did anybody faced this situation?

I was caring for a 26 weeker babe who looked unwell this morning ,the night nurse told me he had frequent desat during night ,he was on nasal oxygen. even I increased the o2 he was not good. he developed severe skin mottling and I observed jerky movements involving both upper and lower limbs with tachycardia.when I alerted the doc she told it is not convulsion but jerks only.his electrolytes were normal blood sugar normal,now I am doubtful what a convulsion is ?How many seconds should it exceed? CRP was sent and it was negative also.finally baby was ventilated.

Friends, How do u set limits on your monitor for High and low ,systolic and diastolic measurements for arterial monitoring. Mean BP we set according to gestational age. Do u have specific guidelines or protocols in your unit.

friends, How often do u check weight for your extreme preemies?Our unit practises Q12h weight checks for all babies including ex.preemies for the first 5days.we place our ex.preemies in Giraffe.It does'nt have a weighing scale.while I take them out of the incubator I am really concerned about hypothermia,accidental dislodgement of ett and umbilical lines.while they write for minimal handling they strictly stick on to q12h weight also.what is the practice in your units/Is there any other options for checking weight for babies inside Giraffe inc/Also what is the Humidity guide lines i9n your unit?Is there specific charts for that according to gestational age and weight? how do u transition humidity?

When does a liver transplant indicated in a neonate.One of my babies will go for an expert opinion for the same within few days.he is a postNEC case with multiple necrosed sites with adown pouring jejunostomy.feeds are ot tollerated ,mother is the donar most probably. but I am hearing about Liver trans for the first time.Can you share with me?

Is there any specific tips in insertion of cannula's in neonates? How many pricks can be done at a time? what is the recommendation. How can I perfectly document after insertion/ Iam not that good in naming veins anatomically? Ihave to do a presentation on this .Dear friends, Do you Know any free downloadable websites.I need some pictures also. Which brand of cannula's do you feel good?

Can you get me tips for peripheral iv insertion in neonates?most of our babes are ex.preterms and our docs keep uvc's and vac's for max of 10 days but sometimes they need TPN's and multiple antibiotics for long duration ,even upto two months.most of our docs are against PICC's because they fear infections.They prefer peripheral better.there are no specially trained ones but we do on experience.some times it is terrible we give blind pricks..How do you document the site of insertion? we simply document it as on left hand or right hand but antomically how can I make clear documentation?

I have odserved large amount of water accumulation in the ventilator tubings,eventhough the water trapper is empty.this occludes the pressure and sometimes baby itself may be figting or the flow sensor may be not functioning.How can we prevent this?Our humdifiers are Fischer and Paykel.

hai Friends, I just want ur valuable opinion n the following concern. we have an outbreak of Pserretiaa And acetinobacter in our unit.this is a level111 NICU,most babies below 28 weeks on prolonged ventilation.(Mst of them are ETT Secretions).DOes the retained secretion and lung pathology itself contribute to this?we change he receptal bags for suction every 3days and also the tubings.most of the babies with CLD WE INSTILL NS for suction.Another cocern is about sealing the iv pricked site (either HEAL or Venous sites ) with Dry cotton .this is our practice after pricking.BUt now our Docs told us not to keep it,apply pressure and clean the site with alcohol. Iwould like to know about the policies in your unit.

Canu suggest the practice in your units for infiltration of Dopamine, calcium, and TPN?

I need immediate help for an iv infiltration with sodium bicarb.the baby is acase of early neonatal sepsis who is in severe metabolic acidosis, who is quiet unstable with severe thrombocytopenia.Central line insertion was failed and had a big blister from extravasation.Please help out .