1. Neonatal resuscitation is required for approximately 10% of newborns, with 1% needing major intervention. Preterm infants are at higher risk of requiring resuscitation.
2. Effective ventilation is the most important part of neonatal resuscitation. Bag-mask ventilation should be performed if the heart rate is less than 100 beats per minute or if the infant has apnea or gasping respiration.
3. Chest compressions are performed if the heart rate remains below 60 beats per minute after 30 seconds of effective bag-mask ventilation with 100% oxygen. Compressions are done at a 3:1 ratio with ventilations at 90 compressions per minute.
Presentation on NRP (Neonatal Resuscitation Program)Moninder Kaur
NRP is neonatal resuscitation program. Approximately 10% of newborns require some assistance to begin breathing at birth. Less than 1% require extensive resuscitative measures. Although the majority of newly born infants do not require intervention to make the transition from intrauterine to extra-uterine life, because of the large total number of births, a sizable number will require some degree of resuscitation.
Presentation on NRP (Neonatal Resuscitation Program)Moninder Kaur
NRP is neonatal resuscitation program. Approximately 10% of newborns require some assistance to begin breathing at birth. Less than 1% require extensive resuscitative measures. Although the majority of newly born infants do not require intervention to make the transition from intrauterine to extra-uterine life, because of the large total number of births, a sizable number will require some degree of resuscitation.
This gives a brief idea about the:
Techniques, Response To NIV, Clinical indications, Contraindications and Evidence Based Decisions on the use of noninvasive ventilation with neonates
This gives a brief idea about the:
Techniques, Response To NIV, Clinical indications, Contraindications and Evidence Based Decisions on the use of noninvasive ventilation with neonates
New Concepts of Newborn Resuscitation – the new national protocolMCH-org-ua
International conference «Actual approaches to the extremely preterm babies: International experience and Ukrainian realities» (Kyiv, Ukraine, March 5-6, 2013)
Neonatal resuscitation also known as newborn resuscitation is an emergency procedure focused on supporting the approximately 10% of newborn children who do not readily begin breathing, putting them at risk of irreversible organ injury and death.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
11. Resuscitation
•Is the newborn term?
•Is the newborn
breathing or crying?
•Does the newborn
have good muscle tone?
•Dry & remove
wet cloth
•Clear airway if
necessary
•Wrap in
prewarmed dry
cloth
•Breast feeds
•Ongoing
Evalution
YE
S
Baby is Delivered
( Ask)
Routine Care
14. Routine Care
• Vigorous term infants with no risk factors
• Babies who required but responded to initial
steps, They now can stay with Mother
• Skin to skin contact recommended
• Clear airway, dry newborn, provide ongoing
evaluation:
– Breathing
– Activity
– Color
• Transfer to New Born Nursery
46. Signs of Effective
Ventilation
Sign of response to ventilation:Sign of response to ventilation:
• Improved heart rate
Signs of improvement in newborn:Signs of improvement in newborn:
• Improved heart rate, color, breathing, tone, and
saturation
48. No improvement
• Is chest rise adequate?
• Is adequate oxygen being
administered?
49. MR. SOPAMR. SOPA
•M- Adjust Mask on the face
•R- Reposition the head to open airway
oRe-attempt to ventilate…if not effective then
•S- Suction mouth then nose
•O- Open mouth and lift jaw forward
oRe-attempt to ventilate…if not effective then
•P- Gradually increase Pressure every few breaths until
visible chest rise is noted
oMax Pip 40cmH2O If still not effective then…
•A- Alternative Airway (ETT or LMA)
50. When to stop ?
• Heart rate above 100/min
• Spontaneous breathing
• Baby in Post Resuscitation care
53. Indication
If after 30 seconds of EFFECTIVE bag
and mask ventilation with 100% oxygen,
Heart Rate is below 60 per minute
Indications
54. • Pump out blood from the heart during
compression and fill up blood in the heart
during release
• Must always be accompanied by ventilation
with 100% oxygen
Principle
56. • Position
– Neck slightly extended with firm support for the
back
– Lower 1/3rd
of sternum between nipple line &
sternum
• Pressure required – depth
– 1/3rd
of the AP diameter of chest
• Rate
– 90/min
Components
60. • Easier with right
hand for right
handed
• Index and middle
or ring fingers
• Other hand used to
support the back
• Pressure applied
vertically
2 Finger Technique
63. • Advantages
• Better control of depth
• Less tiring
• Superior generation of peak systolic & coronary
perfusion pressure
• Nails do not hinder performance
• Disadvantages
• Difficult when baby is big
• Umbilicus difficult to canulate
Preferred method - Thumb
64. Rate
• 3 Chest Compressions then 1 ventilation
• 90 Chest Compressions to 30 ventilations in
one minute
Adequacy
• Palpate femoral/carotid pulse
Rate and Adequacy
65. • Consists of 3 compression & one ventilation
• 120 events in 60 seconds
• 1 cycles in 2 seconds
• ONE- AND – TWO – AND – THREE – ANDONE- AND – TWO – AND – THREE – AND
- BREATH- BREATH
Cycle of events
66. • No pressure to be
applied on ribs,
Xipisternum,
abdomen
• Do not lift
thumbs/fingers
Precautions
68. • HR 60 per minute or more Stop CC, continue
BMV at 40-60/min
• If no improvement, check :
– Effectiveness of BMV
– Oxygen is 100%
– Technique of CC is correct
Evaluation after 30 sec of
CC & BMV
69. When to stop
chest compressions
• When heart rate is 60 per minute or more
70. Key points
• 2 personnel job
• Ensure 100 % oxygen
• Ensure adequate chest movement
during ventilation
• Co-ordinate B & M with CC at 3 : 1
• Check HR every 30 seconds
• Use thumb or 2 finger technique
72. Indications for intubation
• Meconium suctioning in non vigorous baby
• Diaphragmatic hernia
• Prolonged or ineffective ventilation
• Elective
– VLBW
– with CC
78. Additional items
Tape : For securing the tube
Suction equipment
Oxygen
• For free flow oxygen during intubation
• For Use with the resuscitation bag
Resuscitation Bag and Mask
• To ventilate the infant in between intubation
• To check tube placement
79. Positioning the infant
• On a flat surface
• Head in midline
• Neck slightly extended
• Optimal viewing of glottis
83. Lip reference mark: (6 + weight in kilos)
cm
9-10 cm at the lip for
this term infant
84. Tube in Rt. Main bronchus
• Breath sounds only on right chest
• No air heard entering stomach
• No gastric distention
Action
Withdraw the tube, recheck
85. Tube in esophagus
• No breath sounds heard
• Air heard entering stomach
• Gastric distention may be seen
• No mist in tube
Action
Remove the tube, oxygenate the infant with a
bag and mask, reintroduce ET tube
94. Epinephrine
• Formulation 1:1000
• Dilution 1:10000 (Ten times)
0.2 ml in 1.8 ml
• Load 1 ml (in 1ml syringe)
• Dose 0.1-0.3 ml/kg
• Route IV (preferable)
• Rate Rapid bolus
95. Epinephrine
Follow up: if HR < 60 or 0
• Repeat epinephrine q 3-5 minutes
• Ensure:
effective ventilation
effective chest compressions
endotracheal intubation
(if not done already)
• Consider using volume expander
96. What is expected response
• After 30 seconds of administration and
continued PPV and CC
– HR should increase to > 60 bpm
• If no response repeat the dose every 3-5
minutes
• Repeat doses should preferably be give IV
97. “If the baby appears to be in shock
and is not responding to
resuscitation, administration of a
volume expander may be indicated”
!
Shock - HypovolemiaShock - Hypovolemia
98. Signs of Hypovolemia
• Pallor persisting beyond oxygenation
• Weak pulses
• Low blood pressure
• Lack of response to resuscitation
Hypovolemia is a common but often
unrecognized cause of need for
resuscitation
99. Volume Expansion
• Indicated when there is no response to
resuscitation and there is evidence of
blood loss or hypovolemia
• Repeated doses may be necessary if
there is minimal response after the first
dose
• Umbilical vein remains preferred route
but intraosseous acceptable
100. Medication Administration via
Umbilical Vein
• Preferred route for
intravenous access
• 3.5F or 5F end-hole
catheter
• Sterile technique
Placing catheter inPlacing catheter in
umbilical veinumbilical vein
101.
102. Volume Expanders
• Normal saline
• Ringer’s lactate
• Whole blood (O Neg cross matched
with mother’s blood)
This is a critically important skill and the single most important step in the resuscitation of the compromised newborn. The success of resuscitation may be dependent on the effectiveness of this procedure.
To place a catheter in the umbilical vein,
Clean the cord with antiseptic. Place a loose tie of umbilical tape around the base of the cord.
Pre-fill a 3.5F or 5F single end-hole catheter with normal saline.
Connect catheter to stopcock and syringe. Close the stopcock to the catheter to prevent fluid loss and air entry.
Using sterile technique,
Cut the cord with the scalpel below the clamp about 1 to 2 cm from the skin line. The umbilical vein will be seen as a large, thin-walled structure, usually at the 11- to 12-o’clock position.
Insert the catheter into the umbilical vein. The course of the vein will be up toward the heart, so this is the direction you should point the catheter.
Instructor Tip: Keep all umbilical venous catheter insertion supplies together in one sealed bag or tray.
To prevent injury, stop compressions and alert team members when scalpel is being used.