The following guidelines are an interpretation of the evidence presented in the 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations1). They apply primarily to newly born infants undergoing transition from intrauterine to extrauterine life, but the recommendations are also applicable to neonates who have completed perinatal transition and require resuscitation during the first few weeks to months following birth. Practitioners who resuscitate infants at birth or at any time during the initial hospital admission should consider following these guidelines. For the purposes of these guidelines, the terms newborn and neonate are intended to apply to any infant during the initial hospitalization. The term newly born is intended to apply specifically to an infant at the time of birth.

Neonatal resuscitation skills are essential for all health care providers who are involved in the delivery of newborns. The transition from fetus to newborn requires intervention by a skilled individual or team in approximately 10% of all deliveries. This figure is concerning because 81% of all babies in the United States are born in nonteaching, nonaffiliated level I or II hospitals. In such hospitals, the volume of delivery service may not be perceived as sufficient economic justification for the continuous in-hospital presence of personnel with high-risk delivery room experience, as recommended by the American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG). [1] Perinatal asphyxia and extreme prematurity are the 2 complications of pregnancy that most frequently necessitate complex resuscitation by skilled personnel. However, only 60% of asphyxiated newborns can be predicted ante partum. The remaining newborns are not identified until the time of birth. Additionally, approximately 80% of low-birth-weight infants require resuscitation and stabilization at delivery. Nearly one half of newborn deaths (many of which involve extremely premature infants) occur during the first 24 hours after birth. Many of these early deaths also have a component of asphyxia or respiratory depression as an etiology. For the surviving infants, effective management of asphyxia in the first few minutes of life may influence long-term outcome. Even though prenatal care can identify many potential fetal difficulties ante partum, allowing maternal transfer to the referral center for care, many women who experience preterm labor are not identified prospectively and therefore are not appropriately transferred to a tertiary perinatal center. Consequently, many deliveries of extremely premature infants occur in smaller hospitals. For this reason, all personnel involved in delivery room care of the newborn should be trained adequately in all aspects of neonatal resuscitation. Additionally, equipment that is appropriately sized to resuscitate infants of all gestational ages should be available in all delivering institutions, even if the institution does not care for preterm or intensive care infants. Along with the necessary skills, the practitioner should approach any resuscitation with a good comprehension of transitional physiology and adaptation, as well as an understanding of the infant's response to resuscitation. Resuscitation involves much more than possessing an ordered list of technical skills and having a resuscitation team; it requires excellent assessment skills and a grounded understanding of physiology.

What's helping me become a better doctor

Weight loss is the most effective nonpharmacologic measure to decrease blood pressure in overweight individuals. Weight loss with other nonpharmacologic measures can prevent or delay the onset of hypertension and reduce the overall risk of cardiovascular events in such patients. In some patients with established hypertension, lifestyle changes alone may control their blood pressure.

Early Signs that Cancer is Growing in Your Body

Scoliosis is a sideways curvature of the spine that occurs most often during the growth spurt just before puberty. While scoliosis can be caused by conditions such as cerebral palsy and muscular dystrophy, the cause of most scoliosis is unknown.

Parathyroid cancer is a rare disease in which malignant (cancer) cells form in the tissues of a parathyroid gland. The parathyroid glands are four pea-sized organs found in the neck near the thyroid gland. The parathyroid glands make parathyroid hormone (PTH or parathormone). PTH helps the body use and store calcium to keep the calcium in the blood at normal levels.

new sepsis definitions

Bioprosthetic valves used in heart valve replacement generally offer functional properties that are more similar to those of native valves.

-Intrapartum antibiotic prophylaxis for mothers colonized with group B Streptococcus can prevent early-onset neonatal disease. Adequate prophylaxis consists of ampicillin, penicillin, or cefazolin for ;::4 hours before delivery. Regardless of intrapartum treatment, all high-risk infants must be observed for ;::49 hours. A complete blood count with differential and blood culture are indicated if the infant is preterm <37 weeks or was exposed to prolonged rupture of membranes.>18 hrs.

Vegetarian or Vegan? Can I recover?

This was a Nasogastric Intubation that went very wrong. The tube went up into the brain, causing severe damage, instead of going down through the throat.

fingerprints and sweat glands

Acute compartment syndrome refers to ischemic tissue damage secondary to elevated pressures in the enclosed compartments of the lower legs or forearm. When the tissue pressure in an enclosed compartment exceeds the perfusion pressure, the resulting diminished tissue perfusion and compromised blood flow to the muscles and nerves inevitably lead to ischemic tissue necrosis. Majority of the cases involving the lower extremities are due to a traumatic event, most commonly tibial fractures. Other causes include a crush injury or other long bone fractures in a motor vehicle accident, a tight cast or dressing after trauma, and drug overdose.

Lithium, a mood stabilizer used in bipolar disorder, has a narrow therapeutic index (small difference between therapeutic and toxic levels}. This patient's gradual onset of neurologic symptoms (slurred speech, confusion, tremors, and ataxia) is consistent with chronic lithium toxicity. Therapeutic lithium levels are 0.8- 1.2 mEq/L. Serum lithium levels >1.5 mEq/L confirm toxicity, and levels ;::2 .5 mEq/L require emergency management.

Forehead Flap Nasal Reconstruction

Surgical repair of a coexisting ruptured sinus of Valsalva into the RV along with closure of a VSD

This cyst had been slowly growing for decades and created some redundant skin on the surface. A decision was made to make a slightly bigger incision in order to remove this tissue as well. As a result of this deeper process, 2 deep dermal sutures were added before the superficial interrupted sutures were put in place.

This 13 yrs young girl has had left temporo parietal cavernous angioma ,she came with acute bleed with raised ICT ,aphasia ,right hemiparesis ,leision was excised microsurgically with excellent out come

The birth control ring — also called Nuva Ring or vaginal ring — is safe and effective. It prevents pregnancy, and can also help with cramps and other period problems. Here’s how the birth control ring works.