S. T. A. B. L. E. Program Instructor Manual : Post-resuscitation / Pre-transport Stabilization Care of Sick Infants,9780975855942

S. T. A. B. L. E. Program Instructor Manual : Post-resuscitation / Pre-transport Stabilization Care of Sick Infants

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Edition: 5th
ISBN13: 9780975855942
ISBN10: 0975855948
Format: Paperback
Pub. Date: 2006-06-01
Publisher(s): AMERICAN ACADEMY OF PEDIATRICS
List Price: $78.75

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Table of Contents

About the S.T.A.B.L.E. Program xi
Program Development xi
Module Content xi
Course Format: Didactic-Interactive or Self-Study xi
Lead Instructor Qualifications xii
Who Should Participate in S.T.A.B.L.E.? xii
How Long Does it Take to Administer the Learner Course? xiii
How to Use the Instructor Manual xiii
Page Numbering xiii
Answers to Practice Sessions xiii
Program Slides and Hyperlinks xiii
Pre- and Post-Testing xiv
Where Can I Find the Tests? xiv
Administering the Pre-Test xiv
The Post-Test xiv
Administering the Post-Test xiv
Equipment Needed for Program Presentation xiv
Using SecurePack Software xv
System Requirements xv
Navigating the Slide Program in SecurePack xv
Troubleshooting Hyperlinks xv
S.T.A.B.L.E. Program Components xvi
How to Order Program Materials xvi
Renewal Course Options xvii
Option One xvii
Option Two xvii
Beginning the S.T.A.B.L.E. Program Lecture Presentation xviii
Frequently Asked Questions xviii
LEARNER MANUAL
Introduction
1(1)
Program Philosophy
1(1)
Program Goals
1(1)
Newborn Transport
1(1)
The S.T.A.B.L.E. Mnemonic
2(1)
The ABCs
3(2)
Sugar and Safe Care
5(38)
Sugar and Safe Care Module Objectives
6(1)
Safe Patient Care
7(1)
Sugar --- General Guidelines
8(1)
Preparation for Extrauterine Life and Factors that Affect Glucose Stability After Birth
9(5)
Three Main Factors that Impact Blood Glucose After Birth
9(1)
Inadequate Glycogen Stores: High Risk Groups
10(2)
Hyperinsulinemia: High Risk Groups
12(1)
Increased Utilization of Glucose: High Risk Groups
13(1)
Review: Infants at increased risk for hypoglycemia
14(1)
Glucose Monitoring
15(1)
Bedside Monitoring of Blood Glucose
15(1)
Signs of Hypoglycemia
16(1)
Recommended Target Blood Sugar for Sick Infants Who Require Neonatal Intensive Care
16(1)
Initial IV Fluid and Rate
17(5)
Indications for Umbilical Catheterization and Safe Use of Umbilical Catheters
22(6)
Heparin Safety
26(2)
Sugar Module -- Key Points
28(1)
General Approach for the Initial Fluid and Glucose Management of Sick Infants
28(1)
Appendix 1.1 Hyperlink: Malrotation and Midgut Volvulus
29(1)
Appendix 1.2 Classification of Newborns (Both Sexes) by Intrauterine Growth and Gestational Age
30(1)
Appendix 1.3 Hyperlink: IV Insertion
31(1)
Appendix 1.4 Securing a Peripheral IV Using Clear Surgical Dressing and 1/2-Inch Clear Tape
32(2)
Appendix 1.5 Calculating Umbilical Catheter Depth Using a Mathematical Formula
34(1)
Appendix 1.6 Determining Umbilical Catheter Tip Location Using a Graph
35(1)
Appendix 1.7 Example: How To Use the Shoulder-To-Umbilical-Length Measurement Graph to Calculate Umbilical Artery Catheter Insertion Depth
36(1)
Appendix 1.8 Hyperlink: Umbilical Line Malpositions
37(2)
Appendix 1.9 Recommended Actions to Correct the Location of a Malpositioned UAC
39(1)
Appendix 1.10 Hyperlink: Umbilical Catheterization Procedure
40(2)
Appendix 1.11 Securing an Umbilical Catheter
42(1)
Temperature
43(20)
Temperature Module Objectives
44(1)
Introduction
44(1)
Key Concepts
44(1)
Review: Infants at Highest Risk for Hypothermia
45(1)
What is a Normal Core Temperature for Infants and What is Considered Hypothermic?
46(1)
Normal Response to Cold Stress in Term Infants
46(3)
Mechanisms of Heat Loss
49(6)
Conductive Heat Loss
50(1)
Convective Heat Loss
51(1)
Evaporative Heat Loss
52(1)
Radiant Heat Loss
53(1)
Radiant Heat Gain
54(1)
Physiologic Response to Hypothermia: Term and Preterm Infants
55(3)
Norepinephrine and Peripheral Vasoconstriction
56(1)
Norepinephrine and Pulmonary Vasoconstriction
57(1)
Detrimetal Effects of Hypothermia
58(1)
Rewarming the Hypothermic Infant
59(2)
Incubator Method of Rewarming
60(1)
Radiant Warmer Method of Rewarming
61(1)
Temperature Module-- Key Points
61(2)
Airway
63(66)
Airway Module Objectives
64(1)
Airway --- General Guidelines
64(1)
Patient Evaluation and Monitoring
65(1)
Assessment of Respiratory Distress
66(1)
Degrees of Respiratory Distress
66(1)
Respiratory Rate
67(3)
Tachypnea and Low PCO2
68(1)
Tachypnea and Increased PCO2
68(2)
Airway Obstruction
70(1)
Pneumothorax
70(5)
Transillumination for Pneumothorax Detection
71(2)
Pneumopericardium
73(1)
Treatment of a Pneumothorax
74(1)
Respiratory Distress and Work of Breathing
75(1)
Oxygen Requirement
76(5)
The Process of Gas Exchange
76(2)
Tissue Hypoxia and Anaerobic Metabolism
78(1)
Pre- and Post-ductal Oxygen Saturation Monitoring
79(2)
Blood Gas Evaluation
81(1)
Blood Gas Interpretation Using a Modified Acid-Base Alignment Nomogram and S.T.A.B.L.E. Blood Gas Rules
82(9)
S.T.A.B.L.E. Blood Gas Rules
83(3)
Causes of Metabolic Acidosis
86(1)
Treatment of Metabolic Acidosis
86(1)
Causes of Respiratory Acidosis
87(1)
Treatment of Respiratory Acidosis
87(4)
Bag/Mask Ventilation
91(1)
Endotracheal Intubation
92(10)
Supplies and Equipment
92(1)
Assisting with Intubation
93(6)
Location of the Endotracheal Tube on Chest X-ray
99(1)
Initial Ventilator Support
100(2)
Practice Session: Blood Gas Interpretation
102(7)
Pain Control with Analgesics
109(1)
Analgesic Medications
110(1)
Appendix 3.1 Needle Aspiration of the Chest and Chest Tube Insertion Procedures
111(4)
Appendix 3.2 Hyperlink: Respiratory Conditions and Airway Challenges: Congenital Diaphragmatic Hernia, Tracheoesophageal Fistula / Esophageal Atresia, Choanal Atresia, Pierre-Robin Sequence
115(4)
Appendix 3.3 Hyperlink: Oxygen-Hemoglobin Dissociation Curve
119(1)
Appendix 3.4 Hyperlink: Persistent Pulmonary Hypertension (PPHN)
120(4)
Appendix 3.5 Hyperlink: Continuous Positive Airway Pressure (CPAP)
124(1)
Appendix 3.6 Hyperlink: T-Piece Resuscitator
125(1)
Appendix 3.7 Hyperlink: Blood Gas Practice Session
126(1)
Appendix 3.8 Hyperlink: Pain Assessment
127(2)
Blood Pressure
129(26)
Blood Pressure Module Objectives
130(1)
What Is Shock?
130(1)
The Three Types of Shock: Hypovolemic, Cardiogenic, Septic
130(6)
Hypovolemic Shock
130(1)
Cardiogenic Shock
131(1)
Septic (distributive) Shock
132(4)
The Principles of Cardiac Output
136(1)
Factors that Negatively Affect Heart Function
136(1)
Treatment of Shock
136(4)
Treatment of Hypovolemic (low blood volume) Shock
138(2)
Treatment of Cardiogenic (heart failure) Shock
140(1)
Treatment of Septic (distributive) Shock
140(1)
Medications Used to Treat Cardiogenic and Septic Shock
140(2)
Volume Infusions
140(1)
Sodium Bicarbonate 4.2% solution
140(1)
Dopamine Hydrochloride
141(1)
Dopamine Dosing for Newborns and How to Calculate a Final Standardized Concentration of 800 Micrograms per ml IV Fluid
142(3)
Rules for Dopamine Infusion
144(1)
Practice Session: Dopamine rate
145(2)
Appendix 4.1 Hyperlink: Evaluation of Scalp Swelling
147(2)
Appendix 4.2 Hyperlink: Case Study: Baby Doe and It Isn't Just the Lungs: A Case Presentation
149(6)
Lab Work
155(24)
Lab Work Module Objectives
156(1)
Lab work - General Guidelines
156(2)
Laboratory Evaluation
158(1)
Prior to Transport
158(1)
After Transport
158(1)
Neonatal Infection
159(1)
Bacterial Infection
159(1)
Complete Blood Count (CBC) Interpretation
159(7)
Neutrophil Maturation
160(1)
The Absolute Neutrophil Count (ANC)
161(3)
The Immature to Total (I/T) Ratio
164(1)
Platelet Count: Normal Values in Young Infants
165(1)
Initial Antibiotic Therapy for Sick Newborns
166(2)
Preparing for Administration of Antibiotics
166(1)
Antibiotics and Doses -- Ampicillin and Gentamicin
166(2)
Lab Work Module -- Key Points
168(1)
Practice Session: Lab Work
168(5)
Appendix 5.1 Group B Streptococcal Infection
173(1)
Appendix 5.2 Prevention of Perinatal Group B Strepfococcal Disease
174(1)
Appendix 5.3 Indications for intrapartum antibiotic prophylaxis to prevent perinatal GBS disease under a universal prenatal screening strategy based on combined vaginal and rectal cultures collected at 35--37 weeks' gestation from all pregnant women
175(1)
Appendix 5.4 Sample algorithm for GBS prophylaxis for women with threatened preterm delivery
176(1)
Appendix 5.5 Sample algorithm for the management of a newborn whose mother received intrapartum antibiotics for the prevention of early-onset group B streptococcal disease or suspected chorioamnionitis
177(1)
Appendix 5.6 Hyperlink: Updated GBS Guidelines CDC 2002
178(1)
Emotional Support
179(10)
Emotional Support Module Objectives
180(1)
Introduction
180(1)
Helpful Ideas for when the Infant Requires Transport
181(6)
Initial Stabilization Period
181(1)
When the Transport Team Arrives
182(2)
Care of the Family after Transport of the Infant
184(3)
Appendix 6.1 Providing Relationship-Based Care to Babies and Their Parents
187(2)
Quality Improvement
189(16)
Quality Improvement Module Objectives
190(1)
Introduction
190(1)
Quality Improvement Evaluation
190(3)
Classification of Errors
193(2)
Appendix 7.1 Application of Error Types to Baby Doe Case Study
195(2)
Appendix 7.2 Case Study 2
197(4)
Appendix 7.3 Pre-transport Stabilization Self-Assessment Tool
201(4)
References 205

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