This document summarizes the therapeutic hypothermia protocol for treating hypoxic ischemic encephalopathy (HIE) in infants at the OU Children's Neonatal Intensive Care Unit (NICU). The protocol aims to cool infants to a target core temperature of 33.0-34.0°C to prevent or reduce neurologic injury from HIE. The summary describes the criteria for initiating cooling, equipment used, monitoring and charting procedures, rewarming process, and training for nurses on the therapeutic hypothermia team.
Presented the Warmilu IncuBlanket and heat technology to a group of Ministry of Health officials, County Health officials, Chief Medical Officers, Chief Nursing Officers, neonatologists, pediatricians, and other key influencers seeking positive impact in maternal and infant health. We discuss the Warmilu technology and challenges in infant warming as well as context for applications. Presented by Grace Hsia, CEO, on 3/31/2016 at the Sarova Panafric Hotel.
Presented the Warmilu IncuBlanket and heat technology to a group of Ministry of Health officials, County Health officials, Chief Medical Officers, Chief Nursing Officers, neonatologists, pediatricians, and other key influencers seeking positive impact in maternal and infant health. We discuss the Warmilu technology and challenges in infant warming as well as context for applications. Presented by Grace Hsia, CEO, on 3/31/2016 at the Sarova Panafric Hotel.
Perinatal asphyxia is an insult to the fetus or the newborn due to lack of oxygen (hypoxia) and or a lack of perfusion (ischemia) to various organs. Hypoxia ischemia remains a significant cause of neonatal mortality and morbidity and adverse neurodevelopmental outcome. Therapeutic hypothermia found to improve neurodevelopmental outcome in asphyxiated babies.
A presentation for EMS personnel about prehospital cooling of patients with return of spontaneous circulation in the field post cardiac arrest; research and application
Thermoregulation in neonates, or newborn infants, is a critical aspect of their care and well-being. Neonates have limited ability to regulate their body temperature compared to older children and adults. They are highly susceptible to heat loss and have a greater risk of developing hypothermia, which can have detrimental effects on their health.
Several factors contribute to the challenges of thermoregulation in neonates. Firstly, their body surface area-to-weight ratio is higher than that of adults, making them more vulnerable to heat loss. Additionally, neonates have thinner skin and less insulating subcutaneous fat, reducing their ability to retain heat. Their immature nervous systems and limited ability to shiver further complicate their temperature regulation capabilities.
To support thermoregulation in neonates, various measures are taken in clinical settings. Immediately after birth, drying the baby and placing them under a radiant warmer or on a warm, dry surface helps to prevent heat loss. Skin-to-skin contact with the mother, also known as kangaroo care, provides warmth and promotes bonding while stabilizing the infant's temperature.
The use of warm clothing, hats, and swaddling blankets assists in reducing heat loss through evaporation and conduction. Incubators and heated cribs maintain a controlled environment to prevent temperature fluctuations. Additionally, monitoring the infant's temperature regularly and adjusting the ambient temperature as needed are crucial for maintaining their thermal stability.
Preventing overheating is equally important, as excessive warmth can lead to hyperthermia. It is essential to avoid excessive clothing or covering that could cause the baby to overheat.
Ensuring a suitable ambient temperature, promoting skin-to-skin contact, and providing appropriate clothing and thermal support are vital components of neonatal care to maintain a stable body temperature. By carefully managing thermoregulation, healthcare professionals can help optimize the well-being and development of newborn infants.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Perinatal asphyxia is an insult to the fetus or the newborn due to lack of oxygen (hypoxia) and or a lack of perfusion (ischemia) to various organs. Hypoxia ischemia remains a significant cause of neonatal mortality and morbidity and adverse neurodevelopmental outcome. Therapeutic hypothermia found to improve neurodevelopmental outcome in asphyxiated babies.
A presentation for EMS personnel about prehospital cooling of patients with return of spontaneous circulation in the field post cardiac arrest; research and application
Thermoregulation in neonates, or newborn infants, is a critical aspect of their care and well-being. Neonates have limited ability to regulate their body temperature compared to older children and adults. They are highly susceptible to heat loss and have a greater risk of developing hypothermia, which can have detrimental effects on their health.
Several factors contribute to the challenges of thermoregulation in neonates. Firstly, their body surface area-to-weight ratio is higher than that of adults, making them more vulnerable to heat loss. Additionally, neonates have thinner skin and less insulating subcutaneous fat, reducing their ability to retain heat. Their immature nervous systems and limited ability to shiver further complicate their temperature regulation capabilities.
To support thermoregulation in neonates, various measures are taken in clinical settings. Immediately after birth, drying the baby and placing them under a radiant warmer or on a warm, dry surface helps to prevent heat loss. Skin-to-skin contact with the mother, also known as kangaroo care, provides warmth and promotes bonding while stabilizing the infant's temperature.
The use of warm clothing, hats, and swaddling blankets assists in reducing heat loss through evaporation and conduction. Incubators and heated cribs maintain a controlled environment to prevent temperature fluctuations. Additionally, monitoring the infant's temperature regularly and adjusting the ambient temperature as needed are crucial for maintaining their thermal stability.
Preventing overheating is equally important, as excessive warmth can lead to hyperthermia. It is essential to avoid excessive clothing or covering that could cause the baby to overheat.
Ensuring a suitable ambient temperature, promoting skin-to-skin contact, and providing appropriate clothing and thermal support are vital components of neonatal care to maintain a stable body temperature. By carefully managing thermoregulation, healthcare professionals can help optimize the well-being and development of newborn infants.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
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Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
1. Subspecialty Nursing within
the NICU
Therapeutic Hypothermia for
Hypoxic Ischemic Encephalopathy
John W. Karlin, RNC-NIC, CQPA
MSI Certified Team Supervisor
Team Leader, NICU Therapeutic Hypothermia Team
OU Children’s Neonatal Intensive Care
3. Purpose & Policy
Therapeutic Hypothermia
for the treatment of
moderate to severe Hypoxic
Ischemic Encephalopathy
(HIE) for cooling with mild
systemic hypothermia (core
temp 33.0 – 34.0C) to
prevent or reduce the
severity of neurologic injury
associated with HIE.
33.0 C 33.5 C 34.0 C
Target Core Temperature
7. Criteria met; lets Be Cool!
Passive cooling initiated until controlled cooling equipment
is available.
Window of opportunity is 6 hours from time of birth; the sooner
the infant is on cooling equipment, the better.
Minimize delays as much as possible.
Infant will become vasoconstricted with lower core temperature,
making IV access a challenge; obtain IV access ASAP.
Copyrighted photo
of John Travolta
in “Be Cool” 2005
8. Equipment
We are currently using:
3 MTRE Criticools
1 Olympic Brainz Monitor
1 Olympic CFM 6000
https://youtu.be/AegRDBY7rTo
9. Simple,right? Two sizes of whole body wraps:
< 4kg & > 4kg.
Informing the admitting RN is
helpful to reduce waste.
Reorder Kanban is on the 3rd to
last wrap in supply.
aEEG Needles placed subdural
to minimize signal impedance,
or gel electrodes used when
application of needles is not
desirable. Reorder Kanban also
in place for electrode supplies.
* Temp probe
connections will be
different based on
which machine is being
used. Hard Poka-Yoke
* Improper electrode
placement or loose
ground lead will
result in a different
reading.
10. Charting Initial Info. Sheet: To help
keep track of admissions &
provide basic info for
statistical data.
Paper Flowsheet:
Temperatures & basic notes.
CribNotes: Temperatures, etc.
CFM/aEEG: Markers for
anything that would affect the
reading: assessment, BP,
glucose, events, etc.
11. Rewarming&FurtherTesting Rewarming is done
slowly over 8 hours.
Temp increased by
0.2C every 30min
until 36.5C.
Watch for
electrolyte changes,
seizures, & changes
in aEEG.
Infant is 1:1 during
1st & last 8 hours
due to potential
instability.
Data: Initially you will only
have your physical assessment
& CFM/aEEG. Once warm,
expect HUS, EEG & MRI.
P.A.
CFM
HUS
EEGMRI
12. Training Application process to Therapeutic Hypothermia Team,
selection by NICU Management.
New team members go through:
1. 4 hr. A&P class w/ intro. to equipment & charting.
2. Individual 1:1 equipment review.
3. Three 30min aEEG in-service online at Natus.
4. Healthstream: Neonatal Seizures.
5. Five online training courses at Neonatal Care Academy.
6. Final checkoff on process & equipment.
13. That’s it in 10min. Questions?
More info. is in the cooling reference 3-ring binder.
This brief presentation is on Slideshare.
John Karlin, RNC-NIC, CQPA
MSI Certified Team Supervisor
NICU Therapeutic Hypothermia Team
OU Children’s NICU
John.Karlin@OKState.edu
Proud member of the
American Society for Quality
