Journal of perinatology : official journal of the California Perinatal Association
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Review Case Reports
Recurrent seizures in a neonate after lidocaine administration.
We report recurrent seizures in a neonate after intravenous lidocaine administration at the recommended dose for intubation and supplementation of general anesthesia. ⋯ We caution that lidocaine administration to newborn infants at previously accepted doses may result in life-threatening side effects, including prolonged seizures.
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To describe the timing of initiation of administration of parenteral antibiotics to infants with suspected sepsis at birth, identify barriers to prompt administration, and assess the effectiveness of subsequent interventions designed to minimize these barriers. The goals were to administer antibiotics within 1 hour of the physician order and within 2 hours of birth with more than 80% compliance for both goals. ⋯ Administration of the first dose of parenteral antibiotics to newborns with suspected sepsis at birth frequently takes more than 1 hour after the order is written and more than 2 hours after birth. Efforts to identify and minimize common barriers significantly improved the timing of antibiotic administration. Additional improvement was attained by means of continued surveillance and individual feedback to caregivers of infants when timing objectives were not fulfilled.
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To determine the neurodevelopmental status for 5-year-old survivors with birth weights (BW) <801 gm born in the 1980s and to assess differences in outcome for those born from 1986 to 1989 compared with those born from 1983 to 1985. ⋯ For infants with BW <801 gm, survival of infants > or = 24 weeks' gestational age was greater in 1986 to 1989 compared with 1983 to 1985, although the 5-year neurodevelopmental outcome was not different between groups. The significant impact of social risk status on outcome suggests that factors outside the intensive care nursery must be addressed to improve long-term outcome.
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To determine whether 24-hour SNAP scores generated from data gathered by primary bedside nurses agreed with the SNAP scores of one trained research nurse. ⋯ Primary bedside level III nurses can accurately obtain data for SNAP scores during 8- to 12-hour shifts.