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Tuesday, July 30, 2019

CTG machine cardiotocography machine

BT 350 E is the model number .





























 Acquiring the Fetal Heart Signal:: Determine the location of the fetal heart using palpation or a fetoscope. Place the transducer on the maternal abdomen and listen for the fetal heart signal. Reposition the transducer for the loudest fetal heart signal and verify the heart shape icon on the screen is blinking at the fetal heart rate. Secure the ultrasound transducer with the elastic belt. Make sure the transducer is still positioned for the loudest fetal heart signal. Verify the monitor is displaying fetal heart rate values and that the heart shape icon on the screen is blinking at the measured heart rate.

Acquiring Twins’ Heart Rates: Follow the steps outlined in step 2 above to acquire the heart rate for the first fetus. Adjust the ultrasound audio volume for channel one down and channel two up so that the second heart sounds can be heard. Determine the location of the second fetal signal using palpation or fetoscope. Apply gel to the second ultrasound transducer and place it on the maternal abdomen where the second fetal signal was located. Adjust the position of the transducer to find the fetal signal and to maximize its loudness. Secure the ultrasound transducer with the elastic belt. Make sure the transducer BT-350E Operator Manual 27 is still positioned for the loudest fetal heart signal. Also verify the position of transducer one has not changed. Verify the monitor is displaying fetal heart rate values for both fetuses and that the heart shape icons both on the screen are blinking at the measured heart rate.

Detail Procedure for acquiring foetal heart rate :① Explain procedure to the patient. ② Place a probe belt under the patient. ③ Turn the monitor power on. The power switch is located on the front panel. The green indicator located on the front panel when the power on. ④ Determine the position of the fetus using Leopold’s maneuvers. The strongest fetal heart tones are heard through the fetal back. ⑤ Plug the ultrasound transducer cable into the connector labeled “DOP.” ⑥ Apply a small amount of ultrasonic coupling gel to the face of the transducer. ⑦ Place the transducer face down on the maternal abdomen over the area determined to be the fetal back. ⑧ Secure the transducer comfortably in the place by inserting the transducer button through the buttonholes on each end of the belt. ⑨ Volume Up/Down button may be used to adjust the volume. ⑩ Reposition the transducer as necessary until the clearest heart sound is heard. Three to five seconds after a clear heart beat sound is heard, the heart shaped indicator will flash synchronously with the sound. This indicates signal acceptance and recording.

Uterine Contraction (UC):Uterine contraction is measured externally by placing a pressure sensitive device (Tocotonometer) on the maternal abdomen and recording relative pressure changes.
Preparing the Monitor: Turn the monitor on and verify that the normal monitoring screen appears on the display. Remove the monitor from service if an error occurs. Determine whether the monitor is powered from the internal battery or the AC power. If operating on the internal battery, check the power status frame on the display to determine whether the battery has sufficient charge to complete the monitoring session. Use the AC power if the battery is too low. Check the UC transducer to verify proper attachment to the monitor. Check for the proper setting for UC baseline. Adjust as needed.

 Acquiring Uterine Contraction Data: Place the face (button side) of the UC probe on the fundus of the uterus when contractions are not occurring. No gel is required. Secure the UC probe with the belt. The uterine contraction reading at this point should be greater than 30 and less than 90 units. If the readings fall outside this range, the belt may be too tight or too loose. If the belt is over tightened, the contraction peaks may have a flat-top at less than 100 on the UC scale. If the belt is under tightened, the position of the transducer may wander and cause unusable readings. Readjust the belt pressure as needed.

 Monitor Adjustments: Press the UC reference button on the front panel to adjust the values to the baseline. This must be done during non-contraction intervals.

Detail Procedure for Uterine contractions : ① Explain procedure to the patient. ② Place a probe belt under the patient ③ Turn the monitor power on. The power switch is located on the rear panel. The green indicator located under the left side of the printer door illuminates when the power on. ④ Connect the transducer plug to “UC” connector located on the underside of the front cover. Note: When connector or re-connecting the tocotransducer to the monitor’s UC connector, you must wait at least 10 seconds before depressing the UC reference [ ] button. ⑤ Briefly depress the UC reference [ ] pushbutton to set the UC baseline at 10. ⑥ Position tocotransducer on the maternal abdomen over the uterine fundus or where there is the least maternal tissue and the contractions are strongly palpated. ⑦ Connect each end of the belt to the transducer by inserting the transducer button through a buttonhole on the strap. Select a buttonhole that ensure a comfortable fit and holds the transducer securely in the place. ⑧ Between contractions, depress the UC reference [ ] button again. This set UC baseline to 10. The monitor is now ready to begin monitoring. ⑨ If not already activated, depress the [ ] pushbutton located on the front panel of the monitor. The recorder plots the UC on the paper strip chart. CAUTION: The probe belt may cause allergy or skin side effects to patient, if it is used so long time.
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 Event Marker The event marker arrow is provided so that the patient can record the time of important events. The patient merely presses the marker button located on the end of the marker cable at the time an event occurs. This marker time is recorded in the patient record in the strip chart. The event marker icon is an upward pointing arrow. A strip chart printout of the patient record will show this mark.

Clinical Event Marker When an important event occurs like a fetus movement, the clinical event marker is used. If necessary, the doctor will press [ ] button over 2 seconds. Then the doctor can check the important event. The icon is downward pointing arrow. A strip chart printout of this event will show this mark.














Monday, July 22, 2019

Saturday, July 20, 2019

Sunday, July 7, 2019

Drugs and lactation database mother feeding breast feeding

to avoid oral aversion in neonates

Mother feed not available
Formula milk in cup
Ng 1 side attached to nurse's little finger and the other side dipped in FM
 Baby is sucking the finger and getting milk formula milk from nifty cup

https://www.ncbi.nlm.nih.gov/m/pubmed/25129009/

ultrasound in nursery

 it's getting quite compulsory to have a good or basic knowledge (point of care ultrasound ) , for prognosis, a)hydrocephalus monitoring (levene index, AHW (anterior horn width) TOD (thalamo-occipital distance) , b) PVL changes , c) Extreme preterm in DNR decisions.


Functional cardiac echo cardiography is another example

pain management in neonates

cuddling
oral sucrose
iv falgan
fentnyl
and morphine

aim fst shd be to reduce painful stimuli
and thn intervene wd non pharmalogoical interventions and thn go to medicine

Omega 3 fatty acids DHA syrup



Computer table design





Caffeine citrate peyona



Neonatal scores