Tanzeema Hossain BWH

Eirini Nestoridi DPH

Michael Prendergast Steward

Lara Batey, pediatric hospitalist, South Shore Hospital

Hello - Kenia L. Gomez, UMass DBP

Gail Walker from Emerson

Sherman Chu and Nasim Gorji, UMass

Cathleen Renzi Gulen from Lowell General Hospital/Tufts

Cyrus Yau, Berkshire Medical Center

Lindsay Fox MetroWest Medical Center

Krista Birnie Lawrence General

For number 3- does that include mom asymptomatic

Is DPH loosening requirements for hearing screens in light of COVID? Is it ok to just do it outpatient once audiology is open again (probably not for a few months)

hopefully this answers your question, Lisa!

if you haven't already, please chat in your name and organization. If you haven't been getting emails from us about this webinar, please include your email address as well!

ivana culic, beverly/BILH

silvia patrizi Newton Wellesley Hospital

Hi All. Marianne Anderson, MD/AJH

MArie Henderson CNM/ MGH

Katelyn Caton, Charlton Memorial

The same except 2 parents only at once 8am-8pm instead of 24/7

barb stabile bwh

How was been the receptivity to the zoom family support groups?

Virtual Car seat test - how is it done?

Jessica Ninomiya, SCN Nurse Manager, Beverly Hospital

I believe it is a virtual car seat inspection, not the test itself

Tham

Thank You!,

Good job UMass!

great presentations. please do chat in questions and comments!

Does MGH use bubble CPAP (so no ventilator needed) or vent CPAP?

MGH uses vent CPAP

at the moment...

Did you consider going to bubble CPAP to send the vents to the adults?

Yes we have considered it, it was the focus of our NeoQIC RCC project prior to COVID

At BMC we have a strict ration of ventilators now… (but we have always used bubble, so it wasn’t a big deal)

were still working on it, but as im sure you’re aware is a project that requires lots of RT staff and education

work in progress!

Totally- well, you are welcome to visit a NICU with bubble as default.. there are several!

thank you!

SEMC has been very helpful

We at UMass also are planning to transition to bubble CPAP to decrease ventilator use. This is also something we are looking into for our respiratory care collaborative.

Bernadette Levesque has been the bubble CPAP here at BMC — and previously at SEMC…

bubble CPAP “queen”!

Yes and she’s been exceedingly helpful for us as well!

Tufts is using only bubble CPAP and this really saved us in these circumstances

Thank you to Rodica for incredible support!

What is the turnaround time for the results of LDR testing.

2 hrs

Thanks - that makes all the difference. We are still at 24-36 horus.

Knowing what happens to these infants after discharge seems so important. Places like MGH and UMass (and others) where primary pediatric care is largely in the same system as the hospital seem well-suited to look at this. Are folks looking at how infants are doing 2-4 weeks after discharge?

is early discharge at 24 hours?

This is really helpful!

This came up yesterday on PnQIN chat.. hospitals now switching to universal L&D testing… after that NEJM paper last week showed ~14% asymptomatic COVID-19 pos rate among laboring mothers at Columbia

AAP recommends a 48 COVID test for baby, is anyone actually doing a second COVID test at 48 hours? or only if the 24 hour test is positive?

Early discharge is different for c-section vs vaginal

I believe the AAP recommends the follow-up tests at 24, 48 hrs and 5 days depending on if the infant is still admitted…

Early discharge is 24 hours for vaginal and 48h for C-sections.

Are all COVID + moms in negative pressure rooms? Babies separated from mothers, are they in a neg pressure room?

neg pressure room if aerosolizing procedure expected

Hi Nikki, Are you willing to share these BF'ing guidelines for Covid suspect or positive Moms?

otherwise, single pt room

are you keeping babies for the 48 hour test if doing early dc? if dc early, how are you doing the 48 test? are they returning back to the hospital or do you send them to a drive through?

How have families reacted to universal testing for mothers in labor and delivery

How are you dealing with fathers/“healthy caregivers” in care inpatient if mother is COVID+?

Tufts also use bubble CPAP

Most of 48h tests are done in the NICU where babies stay longer. Some in NBN get 48h but not all

support people need to wear masks and perform hand hygiene prior to touching infant when staying in mother’s room

ok thanks for the response

Regarding NP swab in newborns _ is there a recommendation to obtain over 5 min?

Is dad staying in mom’s room? going back and forth to care for baby?

NP swabs, 5 sec in each nares

great idea Munish.

Is anyone else seeing telemedicine being used for low risk newborn visits?

Other than MGH?

Thx - we have a typo in our protocol which says 5 min!! :-)

At BMC we don’t call them, but nearly all go to our own center or community health centers…

Cathleen, we have had some pediatricians do telemedicine for the initial visit for low risk infants, generally with families they know already. All still offer in-person visits.

Yes. Other than MGH. Just trying to get a feel for how common it is.

What if you have more than one baby in the nursery?

The nursery is large enough to have several cribs separated by > 6 feet with PPE for all caregivers or well caregivers.

we have set up COVID nurseries, negative pressure, with neonates in incubator and separated by 6 feet for well newborns who are PUI or positive

Just curious which hospitals are universally screening mothers on L&D? Given rates of asymptomatic positives reported, I imagine the decision to screen all moms vs. selected based on symptoms/risk factors greatly impacts numbers and may influence space issues, other resources .

All of partners universal

We are not here at Anna Jaques Hospital. Until it changes!

At Lowell General, we are testing 48-72 hours prior to scheduled IOL or CS. Not universal for all mothers.

Steward is screening all Moms at 38 weeks... or rapid test on admission if hasn't been done

Brockton universal

Lawrence universal

MWMC- going universal any minute

BIDMC is targeted testing, although they are considering universal. Rapid availability of results is an important consideration!

I think our timing has to do with availability of more rapid test vs one that takes a few days (which is done as outpatient)

UMass is targeted currently. Might change

I can share a bunch of lactation resources.

there is one list at MGH for Covid positive mothers that is followed by 2 triage nurse and one MFM daily.

How does the support person get masks for discharge? you using face coverings?

Targeted at Beverly Hospital. LOVE the ideas about testing everyone at 38 weeks and/or 72 hours prior to scheduled IOLs and C/S!!!

MGH has it as well! Yep

this is a work in progress at MGH. the patient is given one hospital grade mask.

Would NWH be willing to share this handout, ie let other hospitals distribute? It's very nice and haven't seen anything like it on CDC

Leela- I can share MGH one

Thank you!

Handout would be great!

Lawrence is giving cotton masks to our mothers on discharge

thanks everyone.

great presentations

The health dept in Lowell has been helpful with acquiring PPE for covid + families at discharge.

At BMC we have had 13 COVID + mothers deliver, 5 + babies and all babies are healthy

Meg, are more details about those 5 babies available to share?

Meg, are you thinking those 5 are vertical or horizontal?

We are practicing rooming-in at BH for well-appearing Covid suspect mom's and babies. Baby stays in an isolette, 6 feet away from mom while in room and a healthy caregiver can be there for support.

combo- some occurred with strict separation and some with rooming in

c-section vs vaginal deliveries?

was the infant positive at 24hrs separated from birth?

Thank you everyone!!! This has been excellent.

I am here but computer died.

had to go to a different one

can you unmute me?

No problem! see you all next time

Thank you!

Thanks!