corks

Amazon.com has one for $39 if thats any help.:)

You guys should become sales reps for Alaris - you've sold me. :up:Will access there web site and see what they have to offer here in the UK:typing Hey might even get a free lunch out of it!!!!!!!!

i worked as a midwife for years and could not practice to the standard that i wished cos of work load and pressure from management to achieve so may home bookings, home confinements, on top of 24 hr on calls. then one day i went on duty, only midwife on the postnatal ward with a nursing auxillary and whilst helping a first day section breast feed, one of the antenatal ladies delivered down the toilet, she rang the emergency bell but by the time i got there it was all over. later that day i went straight to my manager's office to hand in my notice but she did not wish to loose me so asked me would i work in nicu and they would train me up. so i decided to defect from midwifery. :yeah:never looked back, that was 12 years ago, now i am doing my masters to be an advanced neonatal nurse practitioner.:typing kismet, things happen for a reason and i honestly love the rollercoaster ride of a nicu and the relationships that you develop with families. it is the best job in the world and the job satisfaction is second to none even through the bad times as we are very privileged to have spent time with those babies whose time with us is limited

Don't beat yourself up about it. Have just been reading some articles about it and this is a quote from one of them 'it is a common misconception that occlusion alarms on infusion pumps will signal infiltration. In fact, pumps will alarm only when downstream pressure reaches a specified value, and elevated pressures resulting from infiltration are typically far lower than occlusion alarm triggering levels. In infants, monitoring of inline intravenous pressure is not useful for predicting or detecting infiltration of peripheral catheter sites. Resistance measurements may be useful in detecting infiltration injuries, but are not widely available and at present there are no commercially available infusion pumps that can reliably detect infiltration'

Sorry, my last thread is behind the times, read the first page of replies and did not realise that the babe had turned the corner.Having several senior moments today!!!!!H Good News about babe:yeah:!!!!!!!

We try half EBM and half low birthweight formulas (LBW). We start with the EBM and then give the LBW on top. We don't mix the two in the same bottle. Then we would try progestermil and finally as steve said Soya. Has the babe been investigated e.g pH studies? We had a babe like yours recently, turned out to be pyloric stenosis. Good luck,sometimes these pucky babes need several experimental feeding regiemes before you crack it. lets us know how it goes:up:

Who makes Neoprep? Googled it but came up with nothing. Cheers Corks

Hi Guys, Yet another question from me!!!! Can anyone tell me what the current reccomended pressure limits are for infusion pumps? we use Graesby's and we have low (77-105mmHg), med (200-240 mmHg approx), high (400 mmHg approx). Do you use different settings when administrating TPN? We recently had an extravasation injury with Dex 10% and the pump was at a medium pressure setting:cry:Is there any research on pressure settings?? What type of volumetric or syringe pumps are suitable for neonatal use????? Sorry to bombard you loads of questions but the staff who were involved in the incident were very upset and I have been asked to review the circumstances and make reccomendations. So I would be mega thankful for any help. Ta:bow:

Thanks guys. We don't use bethadine cos of the risk of iodine absorption through the skin with the risk of thyroid problems. It is hard trying to strke a balence between infection control and protecting the integrity of the skin!!!:

Hi Guys, When inserting a peripheral line what do you use to cleanse the skin with? We currently use sterets which contain 70% isopropyl alcohol. :down:That aint gud!!!!!!!!Do you use different solutions dependant on gestational age? Cheers

MgSo4 is a pulmonary vasodilator because of this it can cause hypotension so you end up having to infuse inotropes on top. Hopfully we will start using NO in our unit soon.

Yep we do. We don't have the facility in my unit and would have to transfer the infant to our sister regional unit. Have worked in other units were NO was used sometimes sucessfully sometimes not.

For nNCPAP we run the tubing through the length of the incubator and set the temp control to 40 and the chamber control to minus 3. We have found that reduces rainout.

Viagra is slowly becoming fashionable here in the UK but MgSo4 is still one of the first choices for pulmonary hypertension in our unit. Our consultants are a bit too stiff to try anything up and coming:jester:or am I being too naughty!!!!!!!!!!

For PPHN.

Hydrallinase or normal saline flush outs whereby several needle pricks are made around the site and saline is used to flush. Actiform cool for a dressing-great for pain relief during dressing changes! May need plastics referral. Have seen bad ones with TPN and MGSO4.

Thanks for that. We don't use iodine because of the risk of thyroid dysfunction and use chlorohexidine,limiting contact time to 30 seconds and then wiping off with sterile water. We still use sterets (alcohol swabs) to cleanse the skin for cannula insertion but that concerns me as they contain 70% isopropyl alcohol. It's trying to strike that balance between infection control and maintenance of skin integrity. What do you use when bathing, for example baby bath or do you use plain water?

I recently had to put a reflective piece together on a resusitation which I felt was carried on for too long. Minefield! However I found a framework which is adapted from Gibb's reflective model which may help you for your case study. Don't want to teach you to suck eggs but it might help. I am in the middle of my masters which entails keeping an indept portfolio, basically if I pee I have to reflect on it:bugeyes: 1. Describe a clinical event and identify the key aspects on which you wish to focus and explore further. 2a. Explain the feelings that the event aroused in you. 2b. What do you think were aroused in other people involved( patient, relative,staff)? Provide an explaination of how and why you believe you were aware of their feelings. 3a. Evaluate the impact of your feelings on your decisions and actions? 3b. Discuss the impact of the resources (people and equipment) or lack of resources on your decisions and actions? 4. What alternative/decisions could you have made? What might the consequences of these have been? 5. If this event occurred again, what might you do differently and why? 6. What have you learnt through exploring this event? 7. What learning needs have you identified through reflecting on your practice? Hope this is of some help and all the best.

eventhough there was no recent feed this could still be reflux or aspiration as different babes have different transit times. the blood sugar is high which could be due to stress or infection especially as your blood cultures have shown a growth. do you know what the white cell count was or c reactive protein? this would also confirm infection. sometimes you don't get a full explaination as why these episodes happen but it sounds to me as if you handled the whole situation very professionally. you need to ask one of your senior grades or nurse practitioners for a debrief. your experience would make a good reflective piece if you are maintaining a professional portfolio.:wink2:

hiya, can someone direct me to where i could find evidence based neonatal hygeine and skin care guidelines? would anyone be able to share their unit's guidelines? thanks a million. corks:up:

Hi Guys :balloons: Have not been on line for ages and when I come back it's to pick your brains. Hope you don't mind. Wonder what you clean the preemies skin before procedures like UAC's, LP's and venflons. we recently had a chemical burn from chlorohexidine and we want to write up a guideline to prevent this from happening again. any help gratefully recieved. Your pal, Corks