Baby Day

Last week I had the opportunity to teach neonatal resuscitation (newborn CPR). This is a specific algorithm we learn to use on a baby who is just born but needs some help transitioning to life.  I was very excited to teach this class because it is actually very effective at saving lives.



Unlike adult CPR which has sadly has quite poor outcomes, a few simple steps in the first few minutes of life for a baby can make all the difference in the world. I was able to teach multiple groups of student doctors and student nurses. We all practised together on baby dolls. The groups of learners were very new so it was fun to teach them the very basics and watch them progress as the session went on. The learners were very keen and we had a lot of fun.










Today I was approached by one of the doctors who was doing on call over the weekend. He was excited to inform me he already had the chance to put his skills to the test.

Home made CPAP

A baby was born premature and required some assistance at birth. The baby was transferred to their newborn unit for further support. Today I had the chance to go visit the baby. The baby is on bubble CPAP. I don't have any pictures as I want to protect the confidentiality of the patient. but to the right is a (not so great) photo of what our bubble CPAP looks like on a doll. It is simple a set of adult nasal prongs that would normally  be used to provide a small amount of oxygen to an adult patient. The tubing of the nasal prongs are split. One piece goes to an oxygen flow meter set around 4-6 lmp, the other piece of tubing is put into a bottle of distilled water. The tubing is securely taped so it is exactly 5 cm under the level of the water. This provides the baby with 5 cmh20 of CPAP pressure. CPAP therapy is absolutly critical of a premature baby. Litein hospital was introduced to this therapy recently so I have been able to do some teaching about it to make the use of it even better. Please pray for this little one and her mother as she has quite the battle ahead of her. She weighs less than one pound which is very very challenging to care for in this setting.

If I had the opportunity to make an improvement to the CPAP therapy it would be to make it heated and properly humidified. RTWB is in the process of trying to get heated CPAP systems to Nepal so hopefully we will be able to get one of Litein as well. I know it would be put to good use. Ideally it would also be nice to have a way to run this system on pressurized air as high amount of oxygen can be harmful to these small patients. Unfortunately these little ones are so sick the high oxygen is often necessary just to keep their oxygen levels high in the blood.

So far this teaching session has been the highlight of my trip here. It made me happy to see an excited group learning life saving skills. Sadly, seeing this premature baby has been the lowest part of my trip. I feel discouraged and helpless knowing this baby has a poor prognosis. It can be very overwhelming to see such need for more resources but knowing we are doing our best with limited supplies.