Recent discussions
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Виктория Антонова
In our unit we use epinefrin 0,01 mg/kg first dose IV e second dose on 0,03mg/kg IV -
Виктория Антонова
As a professor at Federal University of Pará during The simulation situation or at delivery room its very important the debrifing with doctors, Residents, nurses abs phisiotherapist -
Виктория Антонова
Se motive at our service improved survival and less need for intubation and BPD with T-piece resuscitator use, especially in preterm infants. -
Виктория Антонова
We do not suction at delivery room online if the babies do not recover espontaneous breathing -
Виктория Антонова
We use T-pierce in all babies who needs especially under 34 weeks -
Виктория Антонова
The airline industry has been using the practice of briefing and debriefing for a long time,to improve safety. The same idea should be present in Medicine, specially in high risk care -
Виктория Антонова
In my experience in the delivery room, especially with neonatology and pediatric residents, having a previous conversation with the multiprofessional team about the care to be provided, considering the possible needs of the child, defining roles for each member of the team, qualifies the care. Debriefing is essential to identify possible inadequacies in care, discuss the reasons that led to the inadequacy so that they do not recur, in addition to sedimenting the sequence of resuscitation procedures. -
Виктория Антонова
The use of a manual T-ventilator in the care of premature newborns in the delivery room has greatly reduced the indication for intubation during resuscitation procedures in the services where I work. The big difference seems to be the possibility of offering CPAP. Establishing and maintaining functional residual capacity soon after initial care and during transport makes a difference. The main problems we face is the quality of the equipment available. Very fragile, the pieces are lost in the sector of sterilization of the components and the great difficulty of acquiring compressed air for the gas mixture to be used during transport. The self-inflating bag is cheaper and easily available in our services. -
Виктория Антонова
Dear Sir/Madam,I have tremendous respect for the committee members for their diligent work but the following improvements could be done to make the babies better quickly without any delay to avoid brain damages from hypoxia and hypoglycemia. The whole life is ahead of them: 1) Suctioning of amniotic fluid causes more hypoxia because it delays the oxygen delivery and delays babies own breathing. It is simply not helping the newborn babies to breathe. It is simply harmful than helpful. 2) 90% of newborn babies are pink without any intervention and achieve Apgar 9 within 1 minute. Therefore remaining 10% who needs help from us, we should help them aggressively to achieve normal oxygen saturation (FT 95-100%; PT 90-94%) within 1 minute; keeping the newborn babies blue up to 10 minutes of life is simply defying the gravity of physiologic needs because babies brain needs 3-4 mL of oxygen/ 100 gm of brain tissues/ minute. During hypoxia babies are not getting any glucose that should be checked in the delivery room, Babies brain needs 3-4 mg of glucose/ 100 gm of brain tissues/ minute. Both hypoxia and hypoglycemia causes brain damages and delays speech, languages and other developmental delays. 3) Babies heart rate should be normal within 15-30 seconds. Adequate oxygen delivery and positive pressure ventilation should be started within 15 seconds without any delay in sick babies. That is the only way we can make babies better quickly and we can avoid medications. As soon as the oxygen reaches the heart, heart rate picks up rapidly and babies improve quickly. Thanks and Highest Regards Dr. Kanjilal -
Виктория Антонова
Thank you for a very well written review of this topic. A problem with all the studies is that there are no measures of the duration of inflation or the peak inflation pressures reported. So it is not possible to know whether the clinicians delivered the randomised treatment and particularly worrying when the subgroups are analysed. This would be a problem with any treatment and needs to be acknowledged in the review.