"The baby only survived because of preparation - not because we are amazing, the system needs to work to support the practitioner in finding the problem " Maryna Venter not realizing how absolutely amazing she really is! #mastersofresus
Neonatal resuscitation carries a very high cognitive load just as a baseline.
There are so many things to think about that we have to offload the things we can - to allow us to think about the things we need to think about.
#mastersofresus
Maryna Venter - Neonatal Retrieval and Resuscitation - Specific considerations, starting with the fact that cold babies die, warming can not be the last consideration.
#mastersofresus
End-tidal side stream ETCO2 draws around 50ml/min to achieve an accurate reading. This means almost half your ventilation disappears to an ETCO2 reading in a micro-prem!
Take it off once the ETT is confirmed
#mastersofresus
Even dead space is a problem with neonates - take the end-tidal CO2, filter and additional dead spacer creaters off the ventilation circuit. Use humidified oxygen to drive the ventilator
#mastersofresus
When it comes to the neonate there is a special consideration for EVERYTHING on the neonate - there is so much that we think we can just adapt from adults to neonates
#mastersofresus
For neonates - if we are mcgiver-ing things for neonates then its probably not the right thing
If we could do the right thing for the neonate we might avoid the arrests
Maryna Venter speaking about neonatal retrieval
#mastersofresus
The annual award for MASTER Resusctiationist was awarded to the "Father of Resuscitation" in South Africa. Thank you Prof Kloeck for the work, passion and energy you have applied to resuscitation in SA!
@Gas_Air_CCdoc@mastersofresus Great to see this large and unique database analysed! I recall seeing a dozen ERT (with some survivors) by Dr. Demetrios Demetriades @HaniAcademic years ago during my surgical rotation as a medical student!
When trying to decide to resus or not - err on the side of caution and on the side of life - but if there is enough information to show that it might be futile you might need to think carefully and advocate for the patient
@AsmaSalloo#mastersofresus
How to remember drug doses for kids? USE AN OFFLOADING TOOL!
The South African PAWPER tape + flipper card, an app on your phone - ANYTHING but your actual brain because maths is hard when you have a small person
#mastersofresus
Severe Pulmonary Embolysm + Shock :
SBP < 90mmHg
Management :
1. Unfractionated heparin 60UI/kg Bolus , then continuous intravenous infusion ; monitor anti Fac Xa
2. Thrombolysis with Alteplase 10mg in 2 mins , then 90mg in 2 hrs
3. Post-thrombolysis for Pulmonary embolysm, continuous iV Unfractionated heparin is ideal,
NOT LMWH nor Fondaparinux
4. if fibrinolysis is contraindicated or if shock persist => surgical or endovascular embolectomy.