Neonatal Resources, the Podcast

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Rebecca and Darla talk head to toe assessment!!!

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Episode Notes:

TTN vs RDS

Neonatal Resources, the Podcast

Listen to Michelle and Darla compare and contrast transient tachypnea of the newborn with respiratory distress syndrome. They talk about:

• Risk factors
• Who is most likely to be impacted
• The importance of developmental care
• Clinical management

There is quite a bit of surfactant discussion, and to be fair, surfactant is often a huge component of NICU management. Check out the Get Your Pens blog To Surf or Not to Surf (if you don’t see a hyperlink, check back, it’s still in process) for a deep dive into methods of surfactant administration, what makes artificial surfactants work, and how the types of surfactant differ.

For visual folks and side by side comparison...Get Your Pens.

References:

Amitai Komem, D., Meyer, R., Yinon, Y., & Levin, G. (2021). Prediction of meconium aspiration syndrome by data available before delivery. International Journal of Gynecology & Obstetrics. https://doi.org/10.1002/ijgo.14034

Alhassen, Z., Vali, P., Guglani, L., Lakshminrusimha, S., & Ryan, R. M. (2021). Recent Advances in Pathophysiology and Management of Transient Tachypnea of Newborn. Journal of Perinatology, 41(1), 6–16. https://doi.org/10.1038/s41372-020-0757-3

Bonk, M. P., & Reilly, J. P. (2019). Clear as Mud: Diagnostic Uncertainty in Acute Respiratory Distress Syndrome. Annals of the American Thoracic Society, 16(2), 197–199. https://doi.org/10.1513/AnnalsATS.201810-697ED

Gomella, T. L., Eyal, F. G., & Bany-Mohammed, F. (2020). Neonatology; Management, Procedures, on-call problems, diseases, and drugs. (8th Ed). McGraw Hill Lange. Chapter 106

Jnah, A. J., & Trembath, A. N. (2019). Fetal and neonatal physiology for the advanced practice nurse. Springer Publishing Company. Chapter 4

Jobe, A. H. (2019). Why, when, and how to give surfactant. Pediatric Research, 86(1), 15–16. https://doi.org/10.1038/s41390-019-0372-1

Ng, E. H., & Shah, V. (2021). Guidelines for surfactant replacement therapy in neonates. Paediatrics & child health, 26(1), 35–49. https://doi.org/10.1093/pch/pxaa116

Razak, A. (2022). Minimally Invasive Surfactant Therapy vs Sham Treatment and Death or Bronchopulmonary Dysplasia in Preterm Infants With Respiratory Distress Syndrome. JAMA: Journal of the American Medical Association, 327(16), 1613. https://doi.org/10.1001/jama.2022.2923
For definitions of the terms we used, check out the full episode page at TTN vs RDS

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In this week’s gestational age episode, we talk about late preterm babies...you know, those “not-sure-how-I-am-gonna-act-just-yet” 34-36 weekers (and why they scare Michelle). We explore:

· Betamethasone for mom and how recommendations have changed

· Cold stress and bathing

· How to use your resources (like this podcast!)

· Why these babies are never a “sure thing” as far as their NICU stay is concerned.

Bibliography

Blackman, I. H. (2014). Factors influencing why nursing care is missed. Journal of Clinical Nursing, 24(1-2), 47-56. doi:10.1111/jocn.12688

Centers for Disease Control and Prevention. (2020). Infant Health. Retrieved from National Center for Health Statistics: https://www.cdc.gov/nchs/fastats/infant-health.htm

Chamberlain, J., McCarty, S., Sorce, J., Leesman, B., Schmidt, S., Meyrick, E., . . . Coultas, L. (2019). Impact on delayed newborn bathing on exclusive breastfeeding rates, glucose and temperature stability, and weight loss. Journal of Neonatal Nursing, 74-77.

Data USA. (n.d.). Hospitals: DataUSA. Retrieved from Data USA: Explore, Map, Compare, and DOwnload US Data: https://datausa.io/profile/naics/hospitals#about

Goodman, D., Little , G., & Harrison, W. (2019). The Dartmouth Atlas of Neonatal Intensive Care. Hanover: The Trustees of Dartmouth College.

Ogboenyiya, A., Tubbs-Cooley, H., Miller, E., Johnson, K., & Bakas, T. (2020). Missed nursing care in pediatric and noenatal care settings: an integrative review. American Journal of Maternal/Child Nursing, 254-264.

Warren, S., Midodzi, W., Newhook, L., Murphy, P., & Twells, L. (2020). Effects of delayed newborn bathing on breastfeeding, hypothermia, and hypoglycemia. JOGNN, 181-189. doi:10.1016/j.jogn.2019.12.004

Notes:

ACOG – American College of Obstetricians and Gynecologists. Want to see their betamethasone recommendation for this population for yourself? It’s here.

Chorioamnionitis (Chorio) – A bacterial infection of the chorion, amnion, and amniotic fluid. Often indicated by a high maternal fever, tender uterus, or foul-smelling amniotic fluid.

Cold Stress – Hypothermia (axillary temperature of less than 97.5° F) which causes an infant to have increased metabolic demands, often leading them to develop hypoxia, acidosis, and hypoglycemia.

Rationing Care – A term used to describe the situation where the nurse must decide which interventions to perform (and which to withhold) in order to accommodate their patient assignment. Read more about it in (Ogboenyiya, Tubbs-Cooley, Miller, Johnson, & Bakas, 2020)

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Thanks for joining us for our pilot episode of Neonatal Resources, the Podcast! We are so excited to get to share with you our passion for this incredible population. We hope that, as the show grows, we can grow together and share practices, insights, and stories. We are nurses, but this isn't limited to nursing. This podcast is aimed at anyone practicing in, or hoping to practice in, the neonatal world.
In this episode, you'll get to hear a little about each of us, what brought us to the NICU, and what keeps us invested. Each of us, Darla, Michelle, and I (Rebecca - it'll usually be this nerdy girl who writes these things!) has a different background and a different approach. For me, our differences have helped me grow, taught me to question myself, and improved my practice. In such a specialized environment, it can be difficult to find the kind of support and encouragement that is required to really flourish in your practice. We hope you'll find some of that here.
What bonds us is a genuine love for what we do. I'm so lucky (can't speak for Darla and Michelle) to have found my life-calling and two of my very best friends in the same place! We are truly grateful to get to share that love and comradery with you and hope that you'll share with us as well. The BIG DREAM for us is to use this platform as a way to grow a community of NICU specialists who want to collaborate and ultimately make the care we provide these vulnerable patients the best it can be.

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Guest Tricia is a Neonatal Nurse Practitioner certified in Palliative Care. Darla and Tricia discuss Palliative Care in the Neonatal settings and the differences between Palliative and Hospice/End of Life Care with the Neonatal Population.

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