Two neos chat!! Temp control// DCC// CPAP??// Manage a preemie!!

[@SridharKs]

Thank you Tala, it was great doing this collab with you. You have a great passion for teaching and for our field, congratulations on the amazing milestone of 25000 subscribers. Hope to do this regularly, God willing.

[@TalaTalksNICU]

Thank you so much! LOVED our chats- and thank you for keeping me on task. Love the way you sum up important information briefly! I need to work on that!! Looking forward to next one!

[@SridharKs]

@@TalaTalksNICU absolutely. Hope you had a nice holiday, welcome back!

[@numnumtv1]

THANK YOU BOTH FOR THIS AWESOME TALK

[@SridharKs]

@@numnumtv1 thank you

[@itzmechristina]

Love love love this new segment ❤ Big THANK YOU to both! ❤

[@TalaTalksNICU]

Oh yay! So happy you found it helpful- we are looking forward to filming more soon

[@Juliana_YT-g5o]

Merci Dr Tala et Dr Sridhar, such amazing, refreshing and informative discussion

[@TalaTalksNICU]

We’re so happy you think so! We loved filming it!

[@sarbarigupta2856]

A wonderful collaboration. Thrilled to see two of my favourite doctors in one frame.

[@TalaTalksNICU]

Oh yay! Thanks for your lovely comment!

[@ranamuhammadarshad6421]

The best initiative..if you discuss real clinical scenarios rather than just text book stuff ❤❤❤❤

[@TalaTalksNICU]

We’re so glad you think so!! Thanks for taking time to comment!

[@docNICU]

thank you very much for this very nice talk and collaborated discussion between the NICU experts working in two different cultures. i am sure there will be further such informative discussion and sharing of experience

[@TalaTalksNICU]

Thank you for your lovely comment- we look forward to filming and getting more videos out soon. Any requests about what you’d like us to talk about?

[@smilerkris]

My two favorite Neos, this is amazing 😍😍😍

[@TalaTalksNICU]

Thank you! :)

[@ashleykeener6150]

Amazing conversation, information, and perspective!

[@TalaTalksNICU]

So glad you thought so- thanks for being here :)

[@lavanyabala4662]

Very usefull . Nice knowing the way of management in different centers

[@TalaTalksNICU]

Agreed! Love seeing what everyone does! Thanks for watching!

[@dianafrancis1808]

Such a wonderful discussion to listen

[@TalaTalksNICU]

Thank you so much Diana! We enjoyed chatting. Really appreciate you taking time to offer encouragement!

[@sreedevinair108]

Thank you for this discussion. Thank you to both Neo’s . ❤❤❤❤

[@TalaTalksNICU]

So glad you liked it! Thank you!

[@carmengalindo8587]

Thank you for the discussion! I would love to see another for micropreemie outcomes. I work at the bedside, and I wonder how they do after the hospital stay.

[@TalaTalksNICU]

Hello! That would be a great discussion- I know Dr SRidhar has his follow up clinic- whereas I don’t/ so I don’t think I’d be enough of an expert to speak comfortably on this! Maybe we can convince him to!

[@m.e.2286]

I follow both of you & am so excited for this collaborative series! I appreciate how you guys compare & share your experiences & relate them to current research studies. I agree with the gentle approach during the extremely crucial intense Golden Hour. Thank you!

[@TalaTalksNICU]

Thank you for your thoughtful comment- we really appreciate you being here :)

[@jackirenee10]

This channel supports my growth as a Nicu nurse! Thank you!

[@TalaTalksNICU]

So happy to read this- thank you so much for being here and for taking the time to write :)

[@laraeb2514]

Nice conversation. It's great to see different points of view. ECG lead placement can be really difficult on these little ones, the ecg leads that come on a heart in one piece were really nice for these kids because you could put them on the back as you apply the plastic bag, unfortunately they are cost prohibitive and only really useful in the intial resuscitation.

[@TalaTalksNICU]

These are great points- as always from you! Glad you liked the conversation- any ideas about other topics we should cover?

[@laraeb2514]

@TalaTalksNICU Maybe neonatal pain management and / or management of delirium in older NICU patients. Epidemolysis Bullosa and maybe a refresher on pressors.

[@NNCCCC63]

top shelf presentation , as always ! God bless you both, and sorry for comparing you to hard liquor...😜

[@TalaTalksNICU]

Hahaha! We’ll take the comparison!!! Thank you so much!

[@emadaljafal1373]

Very very interesting!! It will be so helpful if you can do part 2 from this topic. I have questions regarding this subject which type of cannulation you used in the delivery room peripher. Venen catheter or central catheter. Do you adminstrate caffeine citrate too? and fluid requirements? Thank both you!! always my pleasure to listen to both of you.

[@TalaTalksNICU]

These are SUCH good questions! We need to chat again to cover all of these!! Thank you so much for your great suggestions- we really appreciate you being here!

[@joemygawd]

Love this guy! Thanks!

[@TalaTalksNICU]

He’s so great!

[@jeffjew8393]

Thank you for the discussion

[@TalaTalksNICU]

Thank you for being here!

[@kellywelch134]

This was so informative! We are still a fairly young NICU. I was wondering if you have your sterile plastic bag for Ob to put infant in immediately while doing dcc? Also, I wasn't sure, but did you have plastic lined hats? Do you attempt to dry the chest before putting on leads? Could one of your transport nurses do a video on their role. Thank you so much for this! I really loved this video!!

[@TalaTalksNICU]

Hello Kelly- love your questions. Our OBs don't cover infants with plastic - we do that on the warmer. We don't have plastic lined hats either. And yes generally the chest is dry before putting on leads. (On paper, you put the plastic bag on without drying, but usually during DCC there is some- very gentle- drying happening). I'll try to convince our transport nurses to make a video- but I will say- the hospital I work in currently- they're kinda unicorns! They do a lot more than in most hospitals- but it also means their skills are pretty insane!!

[@kellywelch134]

@TalaTalksNICU thank you so much for answering all my questions! I really get some much from your videos! Thank you for taking the time to make them and answering all the questions!

[@sunil5394]

Tala are you intubating orally or nasally?. Second question and role of pocus for confirming tube position in the delivery suite

[@TalaTalksNICU]

Such good questions. We intubate orally here. I have one colleague that can intubate nasally but I’ve never done it. And POCUS def seems like something we should all be moving to. But the way we have it set up here is we basically do lines etc in our resuscitation room right next to delivery room- and we get X-rays in there.

[@sunil5394]

Wow that seems very efficient. I am sure you have a better success of sticking to the golden rule as against units like ours . We bring the babies up on R pap if possible and site lines in Nicu While R pap is great to let mums get some skin to skin time, I think we loose about 10 mins of the golden hour. Often wondered which was the priority .

[@TalaTalksNICU]

@sunil5394 the thing about working in a hospital is that it’s always a work in progress. The team where I am now have done such an incredible job of ironing out the logistics to set that up. But quality improvement never ends! Can always do better! And every hospital is so different in lay out and space and personnel available that it really isn’t a one size fits all scenario

[@smartman9033]

Thank you both, it was a great lecture Question to dr Tala You have mentioned that you only resuscitate 25 wkr and above! For 22-24 wkr unless if parents request! but if they want comfort care then that will apply ! Based on what? Does NRP say if parents of (22-24wkr) request comfort care then go with parents request? What is your source Thanks Dr Tala

[@TalaTalksNICU]

It has taken me some time to answer you because basically this really depends on where you work. These types of cut- offs are generally made in hospitals. This has become “standard of care” in us in last 15-20 years though. This may be a good place to start www.sciencedirect.com/science/article/abs/pii/S0002937814001690

[@smartman9033]

@@TalaTalksNICU Thank you so much

[@dainaswamy3321]

Knowing that controlling temperature and insensible losses is so important in these ELBW babies, how do you allow for that minute of delayed cord clamping in the OR? Do you just let it happen with the OB holding the baby or do you have the OB deliver into a sterile plastic drape? With a transwarmer? Am I over thinking this? Where I work, we always barely delay the cord clamping and rush the baby to the warmer and the plastic. But maybe we need to rethink this. Also, if the baby is not breathing effectively, how is that delayed cord clamping helping the baby? Maybe I don't understand the physiology, but I thought the baby had to start breathing to make the arterial resistance in the lungs drop and blood start circulating through the lungs and that then that caused the cord to pump blood into baby but not allow blood to return back to the placenta. I have been doing some googling here and haven't quite figured out what happens at birth to tell the cord to give me the bonus blood but not take any back out! I hope that makes sense... please help me understand! I love all of your videos!

[@TalaTalksNICU]

Absolutely not over thinking this- we discuss exactly this point ALL the time!! Unless the baby is not getting any blood from the placenta (eg abruption/ prolapse etc) then generally that extra blood is helpful for the baby. (My good friend who has done SO much research on this has agreed to do a video for us). The blood staying in the baby is a combination of the pressure of the placenta being increased and the baby's pressures being decreased. Dr. Arpi will discuss this more soon- I promise!!! The temp thing is an issue. We need the room to be super warm (which understandably the OBs dont love) and then preferably we need the baby to be covered with warm sterile blankets during DCC. These questions are so smart- and ill be sure to get good answers for you in the video. Thank you!!!!

[@dainaswamy3321]

I can't wait for the video. Thanks! @@TalaTalksNICU

[@dianazamarron2370]

He’s saying for obstetric Dr’s to allow delayed cord clamping for premature babies because he doesn’t expect the babies to be active? Couldn’t hear Dr . Sridhar very well at minute 6:15

[@TalaTalksNICU]

I think the point he’s making- is whether they’re active or not- we should try to do DCC. (Unless something majorly wrong with placenta!)

[@neeva-16]

I have a newborn 25 weeks gestational age micropreemie in the nicu he's 10 days today n I found out he's has grade 3 germinal matrix hemorrhage

[@TalaTalksNICU]

I’m sorry you’re going through such a difficult time. I hope he gets through the NICU stay and has a full happy life ahead of him xx