Recent discussions
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Elene Vanderpas
In our Level 3 centre, we use a plastic bag + hat for less than 32 weeks. We do not usually end up with cold babies post resus who are 32 weeks or greater. But our Infant Transport Team attending deliveries out of hospital will use a plastic bag even for a term baby to help with thermoregulation if they are in a cooler environment. -
Elene Vanderpas
If possible to be made available, an ECG monitor is most reliable for HR, along with auscultation confirmation if concerned about PEA. Pulst oximeter is much less reliable due to more chance of variable signals with decreased perfusion and limb movement. Best to apply ECG leads when commencing PPV, as HR dictates next steps as you are striving to achieve effective ventilation. Think about an adult in ER who is receiving PPV - would you not apply a cardiorespiratory monitor? -
Elene Vanderpas
If available, CO2 detector can be another method to assist in determining if you have a face-mask seal. But since a rising HR is the most important indicator of successful PPV, you will still need to do corrective steps as needed, aside from CO2 detector results. -
Walusa Gonçalves-Ferri
Conventional stethoscope is still an unique option in most of countries. When ILCOR recommending devices and devices to neonate ressuscitation the LMICs are being isolated of the program. Maybe, you should write a recommendation specific to countries with low resources ( 70% of the newborns in the world born in LMICs), if not the ILCOR guidelines will be attending only 30% of the births in the world. -
Giselda Silva
Always below 60 we start cardiac massage -
Walusa Gonçalves-Ferri
As temperature is associated with hemodynamic instability, ILCOR should make a recommendation for rigorous hemodynamic evaluation in hypothermic preterm infants. -
Giselda Silva
The overlapping thumbs technique has been the one of choice in the services where I work in order to facilitate the burden on the NB -
Giselda Silva
I agree that skin-to-skin contact with the mother helps maintain the NB's hypothermia, which becomes more difficult in the case of extremely premature infants. Right away, I don't know if we would have another way of maintaining this temperature in the NB, if not for what is already being done. -
Giselda Silva
in the services where I work in the delivery room, and in most services that I know of here in Rio, the initial method of assessing heart rate in the delivery room is still the stethoscope and eventually we have oximetry in parallel, which greatly facilitates taking decisions. -
Norma Suely Oliveira
We use 2 overlapping thumbs technique