Surgical Insights: Care Of Neonates After A C-sectionSeptember 23, 2013 While rubbing babies and clearing their airways, we also should strive to prevent the three "hypos" in neonates: hypothermia, hypotension and hypoxia. We conclude our three-part article on C-sections with resuscitation and care of the neonates. It is time to change a few old habits and to embrace more modern techniques. Part 1 is here; Part 2 is here. 7. Resuscitation While rubbing babies and clearing their airways, we also should strive to prevent the three "hypos” in neonates: hypothermia, hypotension and hypoxia. Hypoxia is a constant battle during a C-section. The amniotic sac should be removed as soon as possible, and the mouth and airway must be cleared with a bulb syringe. "Don’t use too much suction,” reminds Margret Casal, DrMedVet, PhD, Dipl. European College of Animal Reproduction, University of Pennsylvania School of Veterinary Medicine, "as it could damage the delicate tissue of the pharynx and larynx.” Alternatively, a mucus suction device for human babies can be used, e.g., the poetically called "snotsucker nasal aspirator.” Hypothermia can be prevented by using warm towels straight out of the dryer, or a …
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Two Simple Ways To Improve Patient CareNovember 1, 2011It's fascinating to me that every practice seems to have a different protocol to achieve similar results. For this column, we present better ways to intubate and scrub patients. Each doctor or technician probably has a different intubation protocol. I recently read a description of how we should probably all intubate. It was written by Sheilah Robertson, a board-certified anesthesiologist at the University of Florida College of Veterinary Medicine.1 Here's the idea: Most people test the cuff of a large endotracheal tube by inflating it with a syringe (aka "dry syringe," "air syringe" or "cuffer puffer"), waiting a few seconds, and deflating it. Then, some people lube the tip and the cuff of the tube with lubricating jelly (again, this specifically applies to large tubes). It seems that most do so on a deflated, folded cuff, which actually greatly decreases the benefits. Dr. Robertson suggests adding lube to an inflated cuff. Think about it. It wouldn't take any longer than doing both steps separately, but it would lubricate the cuff much more effectively—on 100 percent of its surface—instead of a few random spots. I have only witnessed one technician do that (surely there are more out there!) But …
