Symptoms And Symptoms Of Neonatal Respiratory Distress Syndrome

* Practicum Goal: * Prevent further complications in respiratory distress by educating the nurse on the use of CPAP and BiPAP to support the patient population with acute respiratory distress and other chronic respiratory illness.

Baker, J & Baker, R.W. (2011) Health Care Finance, Basic Tools for Nonfinancial Managers (3rd Edition). Jones and Bartlett Publishers.

This assignment describes my own reflective experience while caring for a sick neonate with Respiratory Distress Syndrome (RDS) in the neonatal unit. This has enabled me to explore the meaning and significance of my clinical practice and to recognise the complexities within it. The experience raises a number of issues frequently encountered in daily nursing practice. Within this assignment, I will be discussing a particular pre term baby with RDS and critically analyse the use of nasal continuous positive airways pressure (NCPAP) and surfactant therapy and possible effects on baby’s outcome. Pseudonyms will be used to maintain patient confidentiality in order to keep in with the nursing and midwifery council code of conduct. (NMC 2004)The

Both rapid, shallow breathing patterns and hypoventilation effect gas exchange. Arterial blood gases will be monitored and changes discussed with provider. Alteration in PaCO2 and PaO2 levels are signs of respiratory failure. Patient’s body position will be properly aligned for optimum respiratory excursion, this promotes lung expansion and improved air exchange. Patient will be suctioned as needed to clear secretions and maintain patent airways. The expected outcome is that the patient’s airway and gas exchange will be maintained as evidence by normal arterial blood gases (Herdman,

Although when it happens, there can be a devastating impact on patients as well as to the multidisciplinary theatre team involved. Consequently, the DAS has produced a consensus set of guidelines for managing failed intubations in adult and paediatric patients, but there are as yet no such nationally-agreed guidelines in obstetrics, therefore each obstetric unit should have their own flowchart with regards to management of failed intubation (Brien and Conlon, 2013). Furthermore, in light of the latest DAS guidelines, several aspects of clinical anaesthetic practise have changed over recent years (Frerk at al, 2015). Amongst the changes are the use of new drugs such as rocuronium and suggamadex and using electronic video-laryngoscopes (Frerk et al, 2015). Further work had also looked at extending the period of apnoea without causing desaturation by optimising the preoxygenation process and adequate patient positioning (Frerk et al, 2015). As a result, updated guidelines for difficult intubations in adult patients were published in 2015; these guidelines provide a flowchart to be used when endotracheal intubation proves difficult or impossible and focus on the central importance of oxygenation while reducing the amount of airway interventions in order to minimize trauma to the delicate airway (Frerk et al, 2015). The main message of the revised guidelines is

On arrival to UKMC the patient received a Glasgow Coma Score of 3, which is an indication that intubation is needed. Bipap therapy was attempted but failed, due to respiratory failure. This was confirmed by arterial blood gases. After being assessed by the team at UKMC, the patient was intubated for respiratory failure, as well as shock of an unclear etiology. Rapid sequence intubation drugs, Etomidate and Succinylcholine where administered prior to intubation. A 7.5 endotracheal tube was used

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.

Patient outcome consisted of performing 10 deep breaths per hour. We have reviewed details that were difficult for the patient to remember, such as breathing out before placing the lips on the mouthpiece, and holding breath for 3 to 5 seconds at the top of each inhalation. With empathy, I provided understanding that being hospitalized is never easy due to sensory overload, pain and lack of privacy. Additionally, we have discussed the basic pathophysiology of lung inflammation and what it can do to a person. So overall, the outcome included enhanced disease knowledge with effective use of incentive spirometer.

38. American Journal of Respiratory care and critical care Medicine, Volume 175, issue 7, pages 698 – 704

By entering the field of respiratory therapy, one is entering a growing field of opportunity. There are continually emergent job opportunities in this field whereas there is also a rise of growth in the technology and developments in the field such as medicines, techniques, and other aspects.

Approximately 5% of infants born through MSAF develop meconium aspiration syndrome (MAS). About half or more of the affected childrens need mechanical ventilation because of MAS which is severe. It is characterised with pulmonary air leaks and the presence of persistent pulmonary hypertension. MAS is the a common disorder in which neonates are treated with extracorporeal life support. Many management stratagies exists to prevent MAS during parturition, labor, and the first minutes of life. The frequently used treatment is antenatal therapies include amnioinfusion; intrapartum maneuvers include oropharyngeal suctioning prior to delivery of the babies shoulders; the postnatal intervention of intubation for intratracheal suctioning for the non-vigorous meconium-stained

Although there was no evidence of predictors, a strength of this study validates previous studies that showed no improved usage or compliance of CPAP therapy with the addition of heated humidification. This study did, however, confirm a decrease in nasal symptoms with the use of humidification. A limitation of the study is the lack of consecutive patient questionnaires completed, due to occasional time restrictions at the facility.

Newborn intensive care is care for critically ill newborns requiring constant nursing, complicated surgical procedures, regular respiratory support, or other intensive interventions. An infant is considered premature if he or she is born before 37 weeks of gestation and weighs less than 2,500 grams (g). A very low birth weight (VLBW) infant is a child born weighing under 1,500 g

For pediatric patients undergoing procedural sedation, there were no observed differences in clinical outcomes between capnography and standard monitoring. One study looking at the effectiveness of an immediate capnography signal, versus a delayed capnography signal, suggested that an immediate capnography signal was associated with a reduction in the number of hypoxemia events detected. Based on the clinical evidence for capnography compared with standard monitoring, the economic analysis found that capnography was not cost-effective in pediatric patients undergoing procedural sedation. There was no evidence to assess the clinical effectiveness or cost-effectiveness of capnography for pediatric patients undergoing CPR or in post-operative care. For pediatric patients in serious or critical condition, the evidence captured in the clinical review assessed the use of capnography in the neonatal ICU; however, there was insufficient evidence to make any conclusions about the effectiveness of capnography in this population. The cost-effectiveness of capnography for use as a continuous monitor in this population is

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.