Neonatal sepsis. How to use the early onset neonatal sepsis calculator. Dr Sridhar Kalyanasundaram

[@SridharKs]

Useful playlists for nicu nurses, trainee pediatricians and neonatal trainees NRP-kzbin.info/aero/PLKe2uxLSi6cErI1Y7ZRbLub-1Qq8AT4Bm Oxygen in Neonatology kzbin.info/aero/PLKe2uxLSi6cEDL9Zfc57-YJjlVkqJXmQp Neonatal ventilation-kzbin.info/aero/PLKe2uxLSi6cEk8ExzMpF-5ePzmkteTNjk Neonatal jaundice-kzbin.info/aero/PLKe2uxLSi6cFT5aOxCrU9ENBRXlkUwWzq Breastfeeding-kzbin.info/aero/PLKe2uxLSi6cFdnNrlnJQ8T5P-qaP8erc5 And many short videos to clarify queries of new parents-could help if you cover postnatal ward kzbin.info/aero/PLKe2uxLSi6cEAuXao6M9lsXUmbyhbpL1t

[@mulkimire4809]

Thank you explain important topic dr Sridhar you make topics drugs calculate in neonatologist please 🙏

[@SridharKs]

@@mulkimire4809 will try, thank you

[@TheLivert]

Exelent explicaction, thanks

[@SridharKs]

Thank you

[@docjoy]

thanks dr.shridhar . you aptly summarise the EOS calculator. Great

[@SridharKs]

Thank you

[@dr.aurangzebyaqub1160]

sir love from Rawalakot Azadkashmir..Pakistan

[@SridharKs]

Thank you

[@dilipgupta9273]

Sir please make a video on fluid therapy in nicu. Thanks.

[@SridharKs]

Sure. Planning one on fluid and TPN

[@dilipgupta9273]

@@SridharKs Thank u Sir.

[@dragonballbtc4774]

Hello Doctor. My wife is GBS positive and 39 weeks. We are planning on holding off on IAP unless ROM exceeds 4 hours or temperature exceeds 37.5. EOS risk appears to be very low based on our plan. Do you think mainstream algorithms should do something similar to us? Why do they always recommend IAP even for full term GBS positive women with no other risk factors?

[@SridharKs]

There are many mothers who deliver before there is time to give antibiotics. We need to monitor after birth for at least 24 hours and intervene if concerns. Review this What should we do if a mother with positive GBS on screening refuses antibiotics? #GBSpositive kzbin.info/www/bejne/kIqXqZqZf9eIjqM

[@Jasmine93554]

Sir please do video for inotropic calculations

[@SridharKs]

There is a playlist on inotropes. This is to calculate Dopamine infusion. A quick summary of how to prepare the infusion in NICU. Dr Sridhar K kzbin.info/www/bejne/anXaYXyqaMSridk

[@jazeemp9777]

Sir how can I meet you

[@SridharKs]

I work at Al Zahra hospital, Dubai

[@EquippedwithStrength]

May I ask about a case when the mother tests gbs positive from swab, has a reported mild reaction to penicillin, but also a history of severe C-Diff within the last 3 years from Clindamycin (hospitalized for 3 days with colitis). While she is being offered Ancef IV intrapartum, she is struggling to weigh the risk of c-diff recurring in herself with the risk of EOGBS infection in her child. Also to note: her first pregnancy was gbs neg, and delivery was full term and labor was fast. Water breaking to delivery in 90 mins. This is her second pregnancy and will be full term. Is there any information to help this mother decide.

[@SridharKs]

Hi, it is indeed a tricky situation. But please keep in mind that despite the best efforts, a significant number of mothers deliver with inadequate antibiotic cover (if GBS positive) or if GBS unknown. Also, in UK for example, it is more of risk factor based approach (all mothers are not screened for GBS)-so, if you apply that approach to this mother, and monitor the risk factors closely, that would be adequate (no need to expose to clindamycin if stressed). Baby can be monitored (by mother's side, just with vital signs) avoiding discharge for at least 24 (preferably 48 hours).

[@EquippedwithStrength]

@@SridharKs Thank you, this is true, the UK would not treat this mother with anitbiotics if she didn't present with other risk factors. I was also reading that clindamycin is less effective after one dose at 4 hours than penicillin. Can't find as much research into the use of Vancomycin in cases like this. Would a single dose of IV Vanc reach therapeutic level and what are the risks of such a hardcore antibiotic in the newborn. I haven't been able to find much on this.

[@SridharKs]

@@EquippedwithStrength I don’t think it is used for this purpose, as you rightly said, we conserve it for resistant bugs

[@AhmadRaza-ye9qg]

Sir in case of Isolated fever with gestational age18hours without maternal fever, should we start antibiotics.

[@SridharKs]

In most cases, if fever was clearly documented and significant, we would start antibiotics in this group. But in the larger babies in this gestation range, if clinically well and monitored, with monitoring of markers by 8-12 hours, we could wait and start if needed like we do in more mature babies. But document the plan clearly in such cases

[@SridharKs]

For the second question, if it is a term or near term baby, monitoring would be adequate, with option for blood tests if concerns (of course you would include this factor in the sepsis calculator as discussed). In a preterm asymptomatic baby with just PROM and no other risk factor, starting antibiotics or waiting for blood results after 8 hours or so are both acceptable options. This is one of the reasons that the sepsis calculator did not include this group of babies-as only a small group of professionals would hold antibiotics in this group, provided close monitoring by experienced staff is available continuously.

[@AhmadRaza-ye9qg]

@@SridharKs thank you sir. much appreciated

[@SridharKs]

@@AhmadRaza-ye9qg You are welcome. I have posted this discussion on my facebook group too