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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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Agenda
AGENDA

  • BCA at a glance

  • Lessons from Adult BCA

  • Why focus on the newborn

  • BCA for the newborn













10 eating the elephant one bite at a time
10.EATING THE ELEPHANT ONE BITE AT A TIME



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




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


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




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



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



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



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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