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NICU, Med/Surg
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Sweden has 10 years experience and specializes in NICU, Med/Surg.

Sweden's Latest Activity

  1. Sweden


    Hi I´m a swedish nurse and would be glad to help, but I do need a little more information. Anna
  2. Sweden routinely resuscitate at the same gestation age as most of the industrial countries (22-24 weeks). There are only seven neonatal units handling babies at this gestation age (regional hospital´s) and unfortunately everyone is not convinced about the 22-23 weeker. But all above 24 weeks are resuscitated! My unit (and one more) are very active and always have a few 22 weekers in the unit. We have some of the best result in Sweden (and in the world). The cut off for what counts as a live birth (28 weeks like the article said) has been heavily debated and is now changed. Anna
  3. Sweden

    Alarm limits and ROP

    Our limits are 80-95 for all babies with oxygen. We are very cautious to increase (or decrease) oxygen. We have a low incidence of ROP. I can have a baby with sats of 20 and still not increase oxygen. If he/she is on CPAP and not breathing what´s the point....Lots of babies on ventilator are up and down all the time and oxygen levels usually doesn´t change that much... Anna
  4. Sweden

    Food In The Nicu

    KMC = Kangaroo Mother Care
  5. Sweden

    Food In The Nicu

    I seriously doubt that, what about all rest the of the patients in the hospital. I´m just guessing, but I think they get food served to them......... We allow the parents to eat in the ICU area as long as they don't do it during KMC (not that many do). In the private rooms (were babies and parents stay) it´s up to them to decide how to handle food. Anna
  6. Sweden

    Happy Birthday Suzanne

    :redbeathe Happy birthday! I hope you will have a wonderful day! Anna
  7. Sweden

    Questions about managing NICU babies

    1) For premies, when do you start feeding them? Day 2 or 3? I know that if you feed them starting day 1, they can get NEC. In the meantime, do you start TPN? Or is TPN only if the baby is going many days without eating? What kind of IVF do you like to use? D10W + NS or 1/2 NS, + KCL, + Ca? - We start feedings within 2-3 hours of birth, D10 and/or TPN is started as soon as possible (if the baby isn´t on full feeds from the start ofcourse). When you start to feed premies, do you have to slowly advance it, or do you just immediately give them feeds that would have them at 100 kcal/kg/day? - Some are full feeds right away (usually GA > 30 weeks), others advance their feedings as soon as they tolerate it. 2) How much spit up do you tolerate before you decide that either medication or NG tube needs to be used? Do you not care as long as they arent aspirating, brady, apneic, choking, and gaining weight appropriately? - We tolerate spit up as long as the baby otherwise is doing ok and gaining weight (spit up is ok, puking all the time isn´t). Medications for gastric reflux is really uncommon, we don´t see much gastric problems. 3) Do all/most premies get OG/NG even if they have no feeding/airway issues? - No, we try to avoid OG/NG tubes if it´s not absolutely necessary. 4) How do you adjust feed schedule if the baby is on a vent? - Vented patients are fed the same way as all others (bolus fed every 2 hours). The ventilator is not a considered much of a factor when deciding feeding. 5) How much weight is a baby supposed to gain each day? Like 10g or so? - That entirely depends on the baby (GA, condition, current weight and so on). 6) When you start human milk fortifier? Only if the baby has had several days of BM with poor weight gain? Or does every premie get HMF regardless of their weight gain? - HMF is usually started after about 2-4 weeks if he/she isn´t gaining enough weight on just breastmilk (we can go up to 220 ml/kg/day depending on baby´s condition). 7) All these babies are supposed to lose weight for at least the first week regardless of what you feed them, correct? - All babies loose weight, we try to keep it Anna
  8. Sweden

    O2 is 81, what shoud you do?

    Neonates are an entirely different patient group and the same rules don´t apply.... Some of my patients make regular desats down to 10 (sats) and we watch and just stand back and wait for them to recover again. Doing somehing, anything, even just opening the incubator doors only means that the baby will take longer to recover. To stand back even if the patient is doing poorly is one of the hardest lessons one needs to learn doing neonate care. It doesn´t mean that I don´t care about it, I still do an assesment and try to decide the moment when this isn´t ok anymore. Some babies go from 97 to 15 to 96 in just a few minutes, disturbing them just means they will stay longer in the lower range. Sorry, didn´t mean to hijack the thread.. Anna
  9. Sweden

    oldest babies in the NICU?

    We recently had a 18 month toddler (born after 24 weeks, still ventilator dependant) but I do think we hold the record for the oldest "child" because we had a boy here for 20 years. He was home during the day,went to regular school but since he had a syndrome that made him ventilatordependant when he slept he came to the unit to sleep.
  10. Sweden

    Well baby nursery at night

    I don´t think there is a hospital in Sweden that has a nursery, it´s all couplet care. All hospitals allow someone (usually dad and siblings) to stay and help mother and child. Dad gets 10 days paid leave from work to be there for his new familymember. I find it hard to believe that the baby would get the opportunity to feed whenever he/she wants to if they don´t have mom near 24/7 (but I could be wrong.....). Babies at my hospital all sleep with their parents, babybeds are only given to thoose that actually ask for them. If the baby has any kind of problem (hypoglyc/respiratory) they do Kangaroo mother care 24/7. Anna
  11. The parents usually do the daily wash, not the weekly (where everything is taken apart and scrubbed). Most of them see this as something useful to do, we don´t force anyone to do it.... The baby with mold was a extremely sick and tiny 23 weeker, so bathing wasn´t exactly our first priority..... Anna:nuke:
  12. No rings of any kind (germs do not know the difference between a wedding band and another ring). This applies to both staff, parents and visitors. Isolette covers are changed daily along with everything else around the baby. Isolettes are changed weekly but wiped down inside and out daily. Usually one of the parents wash and change everything when the other parent do KMC. It used to be a big pain with changing everything daily since it had to be not only washed but also ironed once dry...... Takes forever to iron an isolette cover not to mention everything else! Now we have a special dryer that heats the fabric enough to kill the germs. Our unit has changed a lot regarding fabric care since we sent samples to infection control. There were LOTS of germs growing on the sheets and other things close to the baby, even if it was just washed. One baby actually had mold growing on her back, and that was the thing that started the whole investigation....... Anna
  13. Sweden

    research on kangaroo care

    Yes, she´s in the Lancet, Acta Paediatrica, Br Med J and Pediatrics. She´s one of the most respected when it comes to KMC research. Anna
  14. Sweden

    Funny/happy NICU moments needed

    I love seeing parents realise that they have actually become parents, that the baby in their arms are inded their child! Traditional care of premature/sick babies usually delay the process a bit, it must be harder if you don´t get to hold your baby. But a few nights ago I admitted 29 week twins (c-section) and got the opportunity to put both babies in their fathers arms within 10 minutes of birth. They went down to the nicu still clinging to dad and his face was lit up with the biggest smile I have ever seen. They both ended up needing CPAP, iv´s, bloodsamples and iv medicine´s, but everything was done with them on dad! He slept with his children on his chest and never left the unit..... Two days later they are off the CPAP and the whole family are together in a private room. I love kangaroo care!!!:redbeathe Anna
  15. Sweden

    research on kangaroo care

    Hi Try searching for articles by Nathalie Charpak, she´s written several good articles. Anna
  16. Sweden

    Californian midwives - need advice!!

    To get your ATT, be able to sit for NCLEX and then recive your RN licence in CA all hours must be covered on a official school transcript. Hospital courses / work experience will not be accepted by the BON. Suzanne, one of the moderators in the international forum is an expert and might be able to give you more information (possible schools). Anna Ps. If you are talking about a midwife licence, just ignore my post and do a search since I know it has been discussed before.