The Importance Of Decision-Making In Neonatal Care

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

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,

Thank you, Maria, for your post! I am a nurse, and I did my clinical in a NICU. I saw first hand what happened to babies born from drug and alcohol abuse mother. Drinking alcohol while pregnant is bad, but I agree with your judgment. Psychiatric medications are considered to have a detrimental effect on the fetus, but when we have pregnant psychotic patients that are violent (I work in psychiatry), we medicate them with a lower dose of medications despite of the damage that it can cause to the baby. We medicate them knowing the risk because it will cause more harm if we live them without medications. This author would never agree with pregnant women drinking alcohol not even in moderation, but I do see your point. If the mother drinks a glass

For the past two decades, the limit of gestational viability has been 22-24 weeks (Bhat, Weinberger, & Hanna, 2012). Around 50 years ago, a premature infant born between 22-24 weeks was not considered viable and resuscitation was only considered at 27-28 weeks (Kushchel & Kent, 2011). Medicine and technology advances have improved neonatology drastically and infants are surviving at lower gestational ages. However, many studies show very low survival rates of 22-week neonates and some physician refuse to resuscitate and provide only comfort care. In the NICHD Neonatal Network between 2003 and 2007, infants that were incubated and resuscitated had a 6% survival rate at 22 weeks and a 55% survival rate at 24 weeks (Bhat et al, 2012). Another study followed a hospital for many years were they delivered 85 infants at 22-week

Another group of patients which require challenging ventilation strategies are the preterm infants. The lungs of preterm infants have undeveloped distal airway structures, with a thick air/blood barrier and a small surface area for gas-exchange (Wallace et al., 2009). They are most likely to be surfactant deficient due to under-developed epithelial cells which lack the type II alveolar cells (Wallace et al., 2009). As a result, preterm infants often require respiratory support in the minutes following birth (Roupie et al., 1995).

Less than 30 years ago the survival rate of premature babies was 25%, now that number has risen to a survival rate of 90%(Dutton, Judy). The increase in this number is most likely due to the advanced medicine and technology and the help of neonatal nurses. By having an advancement in technology and medicine gives us a wider range to work with to help these premature babies survive. Neonatal nurses are there to help contribute to the health of these babies so they can grow strong and healthy. Within nursing, especially neonatal nursing, that has been around since early 1900s have helped save and nurture our babies of the future.

As a father who has personally experienced the struggles and hardships of having a premature child, I feel like giving you information on this subject is a lot easier for me to share than most things. I will preface by sharing my son 's experience; he was born at 26 weeks gestation, weighing 2 pounds, 6 ounces, and spent more than three months in the Neonatal Intensive Care Unit (NICU) that was available in Columbus, Georgia. A large amount of families with infants in the NICU asks what the outlook for babies born earlier than 28 weeks might be? Less than 1 percent of babies in this country are born this early (earlier than 28 weeks), but these babies have the most complications despite great technological advances in medicine today. Premature children born at an extremely low birth weight (less than 2 pounds, 3 ounces) almost always require treatment with oxygen, surfactant, and mechanical assistance to help them breathe (even if for a short period of time until they can breathe on their own without assistance). These babies are too immature to suck, swallow, and breathe at the same time, so they must be fed through a vein (intravenously) until they develop these skills to do so. They often can not cry (or you can 't hear them due to the tube in their throat causing a kitten-like groan), and sleep most of the day to allow for growth and development outside of being in the womb. These tiny babies have little muscle tone,

"Up to 12% of deliveries in developed countries are preterm." This is approximately 500,000 premature births per year. In 2009, my cousin was born ten weeks prematurely, weighing merely two pounds, four ounces. After spending a copious amount of time in and out of the Neonatal Intensive Care Unit (NICU) with my family over the course of a month, I developed an interest in its operation. Being a neonatologist became my leading occupation of interest. I chose to further research this topic in hopes of finding out whether or not this is the career path for me. In my research paper, I plan to go into further detail about the Neonatal Intensive Care Unit (NICU), common medical conditions found in premature infants, how to react and treat these medical conditions, and necessary education to become a neonatologist.

Throughout this essay I will be discussing the holistic impact a premature baby within the neonatal units has on not only the child but also the immediate family. There are many health issues which can affect the child but also other issues including attachment to the mother which can also have a long-term effect on the child. This can also influence the family as there may be financial implications on the family due to these extra unexpected costs. Throughout this essay I will be discussing these topics in detail.

In this essay I will explore the evidence based care of the patient in the above case. It will outline the assessment of an infant with acute bronchiolitis using a suitable framework to determine the appropriate therapeutic intervention. The pathophysiology associated with deterioration and the impact of communication between the family and multi disciplinary team will be explored. This essay will to focus on the initial stages of Joe’s care in the first hour of his admission to the children’s assessment unit.

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

The idea of the viable infant has changed over the years with the continuing progress and growth of the neonatal intensive care unit, making

Premature birth occurs in 11.7% of pregnancies in the United States. With the introduction of new technology in the neonatal intensive care unit (NICU), premature infants are now kept alive at lower birth weights, with more severe diagnoses, and a greater likelihood of surviving to discharge to be cared for by parents.( Brady E. Hamilton; Joyce A. Marti; Stephanie J. Ventura 2012 p.305) An important role to neonatal nursing includes consultation, research, and education of families and staff.

In this article, DiBlasi argues that the conventional method used to provide ventilatory support to preterm neonates with respiratory distress syndrome; nasal continuous positive airway pressure (CPAP) is ineffective. The author bases the claim on the fact that almost half of the infants supported by this technique often develop respiratory failure that warrants invasive ventilatory support and endotracheal intubation that is injurious in nature. According to the author, invasive ventilatory procedures should be avoided to minimize the excessive complications that are usually associated with them.

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