FOR THE NEWBORN
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FOR THE NEWBORN. AGENDA. BCA at a glance Lessons from Adult BCA Why focus on the newborn BCA for the newborn. BCA AT A GLANCE. 10 LESSONS FROM ADULT BCA. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. EATING THE ELEPHANT ONE BITE AT A TIME. Why focus on the newborn?.

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FOR THE NEWBORN

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For the newborn

FOR THE NEWBORN


Agenda

AGENDA

  • BCA at a glance

  • Lessons from Adult BCA

  • Why focus on the newborn

  • BCA for the newborn


Bca at a glance

BCA AT A GLANCE


10 lessons from adult bca

10 LESSONS FROM ADULT BCA


For the newborn

1.


For the newborn

2.


For the newborn

3.


For the newborn

4.


For the newborn

5.


For the newborn

6.


For the newborn

7.


For the newborn

8.


For the newborn

9.


10 eating the elephant one bite at a time

10.EATING THE ELEPHANT ONE BITE AT A TIME


For the newborn

Why focus on the newborn?


Infant mortality in rsa stats sa 2008

INFANT MORTALITYIN RSA ( Stats SA, 2008)


Neonatal deaths in rsa stats sa 2008

NEONATAL DEATHSIN RSA ( Stats SA, 2008)


Drivers of morbidity and mortality

DRIVERS OF MORBIDITY AND MORTALITY

  • Neonatal Sepsis

  • Chronic Lung Disease

  • Necrotising Enterocolitis

  • Periventricular-Intraventricular Haemorrhage

  • Retinopathy of Prematurity


For the newborn

FOR THE NEWBORN


3 major components

3 MAJOR COMPONENTS


Screening bundle

SCREENING BUNDLE

1. Antenatal steroid compliance

2. HIV screening

3. HIV PMTCT compliance

4. Syphilis screening

5. Early NCPAP compliance

6. Cranial Ultrasound compliance

7. Retinal exam compliance

8. Caesarean section rate


For the newborn

CLD

NEC

DRIVERS OF MORBIDITY & MORTALITY

PIH

ROP


Sepsis bundle

SEPSIS BUNDLE

  • Early Bacterial Sepsis (EBS)

    • Vertical transmission

    • Within 72 hours of birth

  • Late Onset Infections (LOI)

    • Healthcare Associated Infection

    • Bacteria, fungal or viral

    • After 72 hours of birth


Sequencing

SEQUENCING


For the newborn

RETINOPATHY OF PREMATURITY

ROP


Rop bundle

ROP BUNDLE

Pulse oximetry on an infant receiving oxygen.

Saturation probe to be placed on the Right or Left hand.

Saturation aimed at 86-92%

Monitor alarm to be set at 85 (low) and 93 (high).

Fundoscopy screening done or booked before discharge.

ROP


For the newborn

CHRONIC LUNG DISEASE


Cld bundle

CLD BUNDLE

Administration of antenatal betamethasone where preterm delivery is inevitable in a pregnancy of 28-34 weeks gestation.

Neopuff use in neonatal resuscitation.

Gentle ventilation (NCPAP) vs (HFO) vs (CV).

Permissive hypercapnia of more than 45mmHg.

Administration of systemic steroids to the infant to prevent or treat CLD.

CLD


For the newborn

NECROTISING ENTEROCOLITIS


Nec bundle

NEC BUNDLE

Breastmilk or pasteurised EBM as a modality of feeding.

Trophic feeds within 24 hours of birth.

Adherence to “volume per day” protocol.

Adherence to “frequency of feeds” protocol.

NEC


For the newborn

PERIVENTRICULAR-INTRAVENTRICULAR

HAEMORRHAGE


Pih bundle

PIH BUNDLE

Administration of antenatal betamethasone where preterm delivery is inevitable in a pregnancy of 28-34 weeks gestation.

Delayed cord clamping for 45 seconds to a minute.

Neopuff use in neonatal resuscitation.

Maintain infant temperature to more than 36 degrees Celsius.

Developmental care: dim lights, low levels of noise and minimal handling.

PIH


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