Module 5 Assignment ( A Presentation Sheet

Neonatal RDS is a condition of increasing respiratory distress commencing at or shortly after birth (BAPM-2006). It’s the single most important cause of morbidity and mortality in preterm infants (Greenough, et al 2004). Typically RDS affects preterm infants with the incidence being inversely proportional to the gestational age (Stewart 2005) Approximately 60% of those born before 28 weeks gestation are affected (Fraser, et al 2004) Incidence also increases in infants of diabetic mothers those born via elective caesarean section (Fraser, et al 2004) and perinatal asphyxia (Rodriguez, 2003).

Compared to the general adult population the maternal airway management can be more challenging as changes during pregnancy can increase the difficulty of intubation (Brien and Conlon, 2013). Its makes hard to insert laryngoscope when the patient have a large breast, the chance of bleeding and swelling increases due to oedema and vascularity of the upper respiratory tract, and the patient desaturate quicker as there is increase in oxygen requirements and there is reduced in functional residual capacity (Mushambi et al, 2015). As a result of all the changes during pregnancy, if the problems encountered during the intubation of Mrs D were to happen to an obstetric patient, it is important to provide optimal surgical condition for to progress rapidly while aiming for a good neonatal outcome (Local theatre policy, 2015b). In obstetric patients, much of the issue is about the urgency with which the foetus must be delivered and the surgical operation must be done as quickly as possible - therefore making decisions in the event of certain clinical situations occurring will require a much quicker decision making process because there is an immediate threat to the life of the woman or foetus (Mushambi et al, 2015). This is why emergency obstetric anaesthesia is such a potentially hazardous

The new versus classic BPD features have changed over the years. The approaches to care, including surfactant administration, permissive hypercapnia, and noninvasive ventilation have changed. All these has increased the survival of low birth weight infants as before with classic BPD. The classic BPD was before surfactant and more management techniques, and inflammation and alveolar septal fibrosis. All these changes were associated with oxygen toxicity, infection, and barotrauma.

Premature birth has been linked to a vast array of lungs problems, the earlier the birth the greater risk of health complications(Davis R and Mychaliska G, 2013). A majority of the health problems will affect the infant for the rest of their life (Davis R and Mychaliska G, 2013). Infants born between the canalicular and the saccular period (week 25) have lung development that is unsuitable for gas exchange (Davis R and Mychaliska G, 2013). Two major complications that arise with undeveloped lungs is bronchopulmonary dysplasia, and pulmonary arterial hypertension (Mahgoub L. et al. 2017).

A major impetus behind the Sarbanes-Oxley Act was deliberate financial statement fraud. When committed on a large scale, billions of dollars can be lost and investor confidence in financial market will be reduced. Evidence suggests that the incidence of fraud has declined relative to the pre-SOX era. This can only be interpreted as suggesting that SOX

According to the World Health Organisation [WHO] (2014) pre-term babies are at increased risk of illness, disability and death. It also states that globally 15 million babies are born pre-term and the figures are rising. In England and Wales during 2012 7.3% of live births were pre-term under 37 weeks nearly 85% of all babies born prematurely will have a very low birth weight (Office for National Statistics, 2012). Pre-term birth is associated with respiratory complications and lung disease, long-tern neurological damage and problems with bowel function (Henderson & Macdonald, 2011). Neonatal services provide care to babies who are born prematurely or are ill and require specialist care. It is seen that sixty per cent of infant deaths occur in the neonatal period (DH,

This goes back to the feedback you were given on the last Complete section which you had questions about. Let me try to address that feedback while giving you examples from your work here. Please note that you have to cite research whether you paraphrase it or quote it directly. The sole differences are that 1) The direct quote goes in quote marks; paraphrased research does not, and 2) That you do not cite with page or paragraph info when you paraphrase. I think what my previous feedback indicated was this: Research use is great. However, I would far prefer few direct quotes. In other words, paraphrase your research rather than quoting directly. Direct quotes should be used extremely sparingly. There

To increase the students’ grade from the D to higher grade, I will be more aggressively in making the students retake the summative assessment. I will be giving the students an academic notice and academic detention in order to booster their current grade to satisfaction level. There will be more formative assessments to pinpoint their weakness. Phone calls will be to students’ guardian to give them the students’ academic status.

Now, medical advances make it possible for even the most severe premature babies to survive. Preterm babies as young as 22 to 23 weeks gestation can survive, but the costs associated with them is high (Kornhauser & Schneiderman, 2010). The higher cost is attributed to the extended hospital stay of micro preemies in Level 3 NICU (Bird, 2014). Level 3 NICU offers a wide range of neonatal services that include special imaging techniques, advanced ventilation

Postnatal respiratory complications among newborns are common. The most commonly reported cause of neonatal respiratory distress is transient tachypnea of the newborn (TTN), with an estimated incidence of 1% to 2% of in all newborns.1

Some of these interventions are as simple as waiting a few more seconds before clamping the cord at delivery and/or milking the umbilical cord, to more advanced interventions such as mechanical ventilation. With any medical intervention, there are side effects and long-term disabilities that may occur in relation to the intervention itself. In the high-intensity NICU, it comes down to weighing the positives and negatives, and choosing the option that will give the neonate the greatest outcome and the best fighting chance of survival. More research needs to be done to determine the long term effects of some of the interventions mentioned in this paper, and how the formerly preterm neonates are living with a disability they may have acquired as a result of those interventions. All medical professionals can hope for is that when a patient comes through the door, they receive the best and most up-to-date care possible, while also remaining free of long term negative effects. As with any population, premature infants - especially those born before 28 weeks of gestation, require strong-willed support from the staff, as well as from their families. It is not easy to care for such fragile human beings, but in the end, when the interventions work, and those neonates are healthy enough to move on with their lives and go home, it all becomes worth

In many neonatal intensive care units, the nasal continuous positive airway pressure is a common mode of respiratory support for preterm infants. (Yong et. al., 2005). During my exposure in the neonatal unit, I have noticed that many of the babies are on nasal CPAP. I believe that this a good choice, given the benefits of using the NCPAP for respiratory support. Improved oxygenation and gas exchange, prevention of atelectasis and apnoea, stabilisation of needed functional residual capacity, and surfactant conservation are advantages of using NCPAP according to Newnam et. al. (2013). Xie (2014) further added that NCPAP lowers upper airway resistance and most importantly, it eliminates the use of endotracheal tube and ventilator along with its

Necrosis of the cells in the small, lower airways occurs, and mucous secretions are increased (Conquest, Cremonesini, & Neill, 2013). Because of the ciliary damage in the infants’ lungs, it is almost impossible for the secretions to be cleared. Bronchiolar level obstruction is caused by these mucosusal secretions, as is desquamation of the dead skin cells and edema (Conquest, Cremonesini, & Neill, 2013). Plugs of soughed, necrotic epithelium and fibrin in the airways will cause partial or total obstruction to airflow, making it very difficult for he infant to exhale which will consequently result in air becoming trapped and will reduce gaseous exchange (Conquest, Cremonesini, & Neill, 2013).

Even though apnea is a limited of time issue and the neonates grow out of it is still a severe issue. There are number of arguments to why premature neonates have apnea from not fully developed brain and weak airway muscles. Other stresses that can worsen apnea in a sick premature; feeding, anemia, heart with lung problems, infection, low oxygen levels, overstimulation and body temperature regulation issues.

Respiratory distress syndrome (RDS) is a common lung disorder that mostly affects preterm infants. RDS is caused by insufficient surfactant production and structural immaturity of the lungs leading to alveolar collapse. Clinically, RDS presents soon after birth with tachypnea, nasal flaring, grunting, retractions, hypercapnia, and/or an oxygen need. The usual course is clinical worsening followed by recovery in 3 to 5 days as adequate surfactant production occurs. Research in the prevention and treatment of this disease has led to major improvements in the care of preterm infants with RDS and increased survival. However, RDS remains an important cause of morbidity and mortality especially in the most preterm infants. This chapter reviews the most current evidence-based management of RDS, including prevention, delivery room stabilization, respiratory management, and supportive care.