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1.
Artigo em Inglês | MEDLINE | ID: mdl-32273302

RESUMO

In October 2019, the British Association of Perinatal Medicine (BAPM) published a Framework1 and associated infographic2 for 'Practice on Perinatal Management of Extreme Preterm Birth Before 27 Weeks of Gestation' This outlined an approach, based on data from the UK and abroad, to assist clinicians in decision-making relating to perinatal care at ≤26+6 weeks gestation. Many frontline providers of delivery room care of extremely preterm infants will have completed a Resuscitation Council UK (RCUK) Newborn Life Support or Advanced Resuscitation of the Newborn Infant course. This RCUK response to the BAPM Framework highlights how this might impact on their approach.

4.
BMJ ; 360: k212, 2018 01 18.
Artigo em Inglês | MEDLINE | ID: mdl-29348150
6.
Arch Dis Child Fetal Neonatal Ed ; 97(4): F246-8, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22102634

RESUMO

OBJECTIVE: To ascertain whether Newborn Life Support Course (NLS) accredited trainees could demonstrate resuscitation skills appropriate to their level of training by providing standardised assessments of both junior and senior paediatric trainees during their induction period. DESIGN: Retrospective review of medical staff resuscitation assessments over an 8-year period from 2003 to 2010. SETTING: A network-lead tertiary neonatal service with over 11 000 deliveries annually. PARTICIPANTS: Neonatal medical staff: junior (speciality trainee(ST) of years 1-3) and senior trainees (ST 4-8 with tier 2 on-call responsibilities). INTERVENTION: A standardised criterion-referenced assessment was performed by two NLS instructors. Junior trainee assessment focused on the basic airway skills learnt on an NLS course. Senior trainees demonstrated resuscitation of a baby with meconium-stained liquor, focusing on advanced life support, including intubation of the mannequin. MAIN OUTCOME MEASURES: Assessment outcomes were pass/fail; fails were categorised as algorithm failure, technical skills failure or both. For trainees who failed the first assessment, the outcome of the second assessment following appropriate feedback was recorded. RESULTS: Two hundred and sixty-two assessments were performed: 160 junior and 102 senior trainees; 98/160 (61%) of junior and 57/102 (56%) of senior trainees passed their first assessment; 69% of junior trainees who failed the first assessment had a second assessment recorded. There was a 79% pass rate at second assessment; 89% of senior trainees who failed a first assessment had a second assessment recorded. There was an 85% pass rate at second assessment. The majority of trainees who failed an assessment had problems with both the resuscitation algorithm and technical skills. CONCLUSIONS: Significant numbers of trainees who have been formally trained in neonatal resuscitation skills previously do not pass the standardised resuscitation assessment, thus require an additional input to maintain their competence in neonatal resuscitation.


Assuntos
Educação de Pós-Graduação em Medicina/métodos , Cuidado do Lactente/normas , Neonatologia/educação , Ressuscitação/educação , Competência Clínica , Educação Baseada em Competências/métodos , Educação Baseada em Competências/organização & administração , Educação de Pós-Graduação em Medicina/organização & administração , Avaliação Educacional/métodos , Inglaterra , Humanos , Cuidado do Lactente/métodos , Recém-Nascido , Manequins , Ressuscitação/métodos , Ressuscitação/normas , Estudos Retrospectivos
7.
Eur J Pediatr ; 169(2): 187-90, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19495793

RESUMO

OBJECTIVE: The purpose of this study is to establish whether omitting routine postnatal examination on maternity units increases the risk of hospitalisation in the first week of life of the newborn. STUDY DESIGN: Retrospective analysis of maternal and baby details and paediatric admission data spanning 12 months in the setting of two maternity units and children's admission unit (CAU) at the University Hospitals of Leicester NHS Trust, Leicester, UK looking at all live-born babies not admitted to neonatal units (n = 7,058). MAIN OUTCOME MEASURES: For babies within first week of life, main outcome measures are: (1) risk of the need to be assessed on CAU and (2) risk of hospitalisation for 48 h. RESULTS: Babies who had routine postnatal examination on maternity unit (n = 3,631) and babies who had no such examination (n = 3,427) had similar risks of the need to be seen on CAU (3% and 2.4%, respectively; p = 0.057) and of hospitalisation for 48 h (0.82% and 0.67%, respectively; p = 0.22). Babies born to first-time mothers and/or premature were more likely to have postnatal examination on the maternity unit and were at a higher risk of hospitalisation in the first week of life. CONCLUSIONS: With prudent selection and extended surveillance of at-risk babies, lack of routine postnatal examination on maternity unit did not increase the risks of hospital review or admission in the first week of life. Worryingly, however, as many as 27% of all babies might not have had routine postnatal examination at all.


Assuntos
Anormalidades Congênitas/diagnóstico , Maternidades/estatística & dados numéricos , Centros de Saúde Materno-Infantil/estatística & dados numéricos , Admissão do Paciente/tendências , Exame Físico , Cuidado Pós-Natal/métodos , Anormalidades Congênitas/epidemiologia , Seguimentos , Humanos , Incidência , Recém-Nascido , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Reino Unido/epidemiologia
8.
Arch Dis Child Fetal Neonatal Ed ; 92(3): F181-4, 2007 May.
Artigo em Inglês | MEDLINE | ID: mdl-17095545

RESUMO

INTRODUCTION: Many changes have been made to the staffing and organisation of neonatal care in the UK in the past 10 years. This study assessed the extent to which these changes had affected the transfer of babies between different parts of the service. METHODS: Data from the Trent Neonatal Survey, an ongoing study of neonatal intensive care activity in the former Trent Health Region of the UK, were used to evaluate neonatal inter-hospital transfers over a 10-year period, from 1 January 1995 to 31 December 2004. The number of transfers and the types of transfer were analysed and trends in gestation and disease severity over the study period were assessed. Rates of "inappropriate transfer" were also identified. RESULTS: 8105 babies were transferred over the period; 2294 babies underwent urgent postnatal transfer and this equates to approximately two such transfers every three days. The maximum number of journeys by any one baby was eight. Intensive care activity rose during the 10 years but the number of inappropriate transfers remained persistently high. CONCLUSIONS: Organisational changes in neonatal care during the 10-year period have been insufficient to deal with the rising demand, as reflected by the persistently high rate of inappropriate transfers.


Assuntos
Mau Uso de Serviços de Saúde/tendências , Terapia Intensiva Neonatal/normas , Transferência de Pacientes/normas , Assistência Perinatal/normas , Inglaterra , Idade Gestacional , Mau Uso de Serviços de Saúde/estatística & dados numéricos , Humanos , Recém-Nascido , Terapia Intensiva Neonatal/organização & administração , Terapia Intensiva Neonatal/tendências , Transferência de Pacientes/organização & administração , Transferência de Pacientes/tendências , Assistência Perinatal/organização & administração , Assistência Perinatal/tendências , Prática Profissional , Fatores de Risco , Transporte de Pacientes
9.
Acta Paediatr ; 95(5): 519-22, 2006 May.
Artigo em Inglês | MEDLINE | ID: mdl-16825129

RESUMO

UNLABELLED: Until the advent of aseptic deliveries and aseptic umbilical cord care, many deaths occurred from umbilical infections. Omphalitis is a localized infection of the umbilical cord stump, most commonly caused by a single organism, which usually responds well to appropriate antibiotics. Umbilical sepsis is relatively uncommon in the developed world but is endemic in less-developed regions. Complications of omphalitis are exceedingly rare, but potentially catastrophic. Many of these babies will require surgical intervention. This paper aims to review the serious complications of omphalitis and how these should be managed. CONCLUSION: It is important to be aware of the rare but potentially lethal complications of omphalitis. Prompt recognition of serious sequelae is crucial for survival.


Assuntos
Infecções Bacterianas/complicações , Umbigo , Infecções Bacterianas/diagnóstico , Infecções Bacterianas/terapia , Humanos , Recém-Nascido , Inflamação/diagnóstico , Inflamação/etiologia , Inflamação/prevenção & controle
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