Prostaglandin

The team began to prepare the medication according to your management plan. Meanwhile, the consultant subsequently arrives, and is worried that baby has cyanotic congenital heart disease in light of murmur and persistently low oxygen saturations.

She agrees with your management that baby needs a prostaglandin infusion, and advises contacting paediatric cardiology at the referral centre for advice and transfer. She also recommends that baby is intubated and ventilated due to the risk of respiratory failure.

You liaise with the local paediatric neonatal/cardiology centre, and explain that you are concerned about a possible duct dependent pulmonary circulation. They advise starting prostaglandin infusion at 5 nanograms/kg/minute, with a view to increasing to 10 nanograms/kg/minute if baby’s condition fails to improve.  The target oxygen saturations should be between 75-85%. The neonatal transport team are currently busy on another retrieval. They have estimated that they will arrive in around 2 hours’ time.

Your registrar offers to help by writing up the infusion and you gladly accept their help with this complex calculation. You begin drafting the transfer letter whilst the consultant and registrar discuss the baby’s condition with the family.

You are called by the neonatal nurse as baby Bella’s oxygen saturations continue to deteriorate, and have drifting below 70%. The infusion has been running at 5nanograms/kg/min for the last 10 minutes. You review the prescription together.

What should be done next?

  • Increase rate to 10nanograms/kg/min
  • Stop the infusion and change prescription
  • Call consultant

Map: TAME case 6- Bella (Tutorial 1) (328)
Node: 8136
Score:

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OpenLabyrinth
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  • Tamponul de liză
  • Chest radiograph
  • Pine tree cones
  • Iodine Test
  • You request labs, x-rays and explain more about pain management
  • new node
  • Mitosis
  • Ignora a su madre.
  • Νεφελoποιημένη Αδρεναλίνη
  • DNA Isolation: Experimental reagents
  • Τον παραπέμπετε για μια Ακτινογραφία Θώρακος σήμερα
  • Surfactant -Frusemide
  • new node
  • Ionel vrea doar să se joace și nu se implică în celelalte cursuri.
  • Observe him for a few hours
  • Give Surfactant via Endotracheal Tube
  • Node 2: Discuss Maria's feelings and concerns
  • Turn to alternative non-traditional medicine/self-medication.
  • Ο οδοντίατρος αμέσως διαπιστώνει , με βάση την εμπειρία του, την πάθηση της ασθενούς και της ανακοινώνει περί τίνος πρόκειται.
  • You suggest that we work together with the doctors at the hospital.
  • Μέτρηση ζωτικών σημείων
  • Θα κάνετε την αξιολόγηση την επόμενη φορά, δεν θέλετε να την πιέσετε
  • Start intravenous antibiotics
  • Insist on outpatient monitoring and treatment.
  • Ενδοφλέβια δεξαμεθαζόνη
  • new node
  • Proteinaza K
  • Η δόση ακτινοβολίας θα παραμείνει η ίδια
  • She still resists making a doctor's appointment
  • She gets worried and makes a doctor's appointment
  • Faint
  • Μας παίρνει τηλέφωνο μία μέρα μετά, ότι ο συγγενείς του ανακοίνωσε ότι θα δώσει άμεσα τέλος στην ζωή του
  • Попросити лікаря негайно відновити мій ритм. Ці симптоми мене дуже сильно турбують.
  • >Να διπλασιάσουμε το αριθμό των φωτονίων.
  • Clinical examination
  • Wash buffer
  • ΕΞΕΤΑΣΗ ΟΦΘΑΛΜΙΚΗΣ ΚΙΝΗΤΙΚΟΤΗΤΑΣ
  • Sodeloval bo pri vseh krožkih.
  • Onion root tip
  • Prostaglandin

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