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NeoQIC: Care of Newborns Impacted by COVID-19 - Shared screen with speaker view
Tanzeema H
19:51
Tanzeema Hossain BWH
Eirini Nestoridi
19:58
Eirini Nestoridi DPH
michael prendergast
20:03
Michael Prendergast Steward
Lara Batey
20:13
Lara Batey, pediatric hospitalist, South Shore Hospital
Kenia L. Gomez
20:14
Hello - Kenia L. Gomez, UMass DBP
GWalker
20:18
Gail Walker from Emerson
Sherman & Nasim (UMass)
20:20
Sherman Chu and Nasim Gorji, UMass
Cathleen Renzi
20:37
Cathleen Renzi Gulen from Lowell General Hospital/Tufts
Cyrus Yau
20:53
Cyrus Yau, Berkshire Medical Center
Lindsay Fox
20:54
Lindsay Fox MetroWest Medical Center
Krista Birnie
21:22
Krista Birnie Lawrence General
nicolerandazzo-ahern
26:29
For number 3- does that include mom asymptomatic
lisa capra
30:10
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)
Munish Gupta
32:16
hopefully this answers your question, Lisa!
Munish Gupta
34:29
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!
ivanaculic
34:58
ivana culic, beverly/BILH
Silvia Patrizi
35:09
silvia patrizi Newton Wellesley Hospital
Manderson
35:09
Hi All. Marianne Anderson, MD/AJH
Marie's iPad
35:36
MArie Henderson CNM/ MGH
Katelyn C.
35:55
Katelyn Caton, Charlton Memorial
Zuzanna Kubicka SSH/BCH
36:18
The same except 2 parents only at once 8am-8pm instead of 24/7
bbs
36:40
barb stabile bwh
Meg ParKer
42:53
How was been the receptivity to the zoom family support groups?
Lucienne's iPad
44:59
Virtual Car seat test - how is it done?
Jessica Ninomiya
45:19
Jessica Ninomiya, SCN Nurse Manager, Beverly Hospital
Meg ParKer
45:29
I believe it is a virtual car seat inspection, not the test itself
Lucienne's iPad
46:50
Tham
Lucienne's iPad
47:04
Thank You!,
Kenia L. Gomez
48:01
Good job UMass!
Munish Gupta
51:35
great presentations. please do chat in questions and comments!
Meg ParKer
54:04
Does MGH use bubble CPAP (so no ventilator needed) or vent CPAP?
Megan Aurora
54:20
MGH uses vent CPAP
Megan Aurora
54:38
at the moment...
Meg ParKer
54:38
Did you consider going to bubble CPAP to send the vents to the adults?
Megan Aurora
55:02
Yes we have considered it, it was the focus of our NeoQIC RCC project prior to COVID
Meg ParKer
55:15
At BMC we have a strict ration of ventilators now… (but we have always used bubble, so it wasn’t a big deal)
Megan Aurora
55:25
were still working on it, but as im sure you’re aware is a project that requires lots of RT staff and education
Megan Aurora
55:46
work in progress!
Meg ParKer
55:49
Totally- well, you are welcome to visit a NICU with bubble as default.. there are several!
Megan Aurora
55:58
thank you!
Megan Aurora
56:12
SEMC has been very helpful
Sherman & Nasim (UMass)
56:40
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.
Meg ParKer
57:16
Bernadette Levesque has been the bubble CPAP here at BMC — and previously at SEMC…
Meg ParKer
57:30
bubble CPAP “queen”!
Megan Aurora
57:33
Yes and she’s been exceedingly helpful for us as well!
Rodica Turcu
57:43
Tufts is using only bubble CPAP and this really saved us in these circumstances
Sergei Roumiantsev
59:08
Thank you to Rodica for incredible support!
ivanaculic
01:00:19
What is the turnaround time for the results of LDR testing.
Megan Aurora
01:00:30
2 hrs
ivanaculic
01:00:50
Thanks - that makes all the difference. We are still at 24-36 horus.
Munish Gupta
01:01:21
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?
ivanaculic
01:02:02
is early discharge at 24 hours?
Silvia Patrizi
01:02:05
This is really helpful!
Meg ParKer
01:02:17
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
Cyrus Yau
01:02:23
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?
Megan Aurora
01:02:37
Early discharge is different for c-section vs vaginal
Meg ParKer
01:03:07
I believe the AAP recommends the follow-up tests at 24, 48 hrs and 5 days depending on if the infant is still admitted…
Sergei Roumiantsev
01:03:07
Early discharge is 24 hours for vaginal and 48h for C-sections.
H. Ozlem Kasaroglu
01:03:08
Are all COVID + moms in negative pressure rooms? Babies separated from mothers, are they in a neg pressure room?
Megan Aurora
01:03:36
neg pressure room if aerosolizing procedure expected
Jessica Ninomiya
01:04:17
Hi Nikki, Are you willing to share these BF'ing guidelines for Covid suspect or positive Moms?
Megan Aurora
01:04:19
otherwise, single pt room
Cyrus Yau
01:04:32
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?
katesullivan
01:04:45
How have families reacted to universal testing for mothers in labor and delivery
Lindsay Fox
01:04:54
How are you dealing with fathers/“healthy caregivers” in care inpatient if mother is COVID+?
Maryann V. Volpe
01:05:20
Tufts also use bubble CPAP
Sergei Roumiantsev
01:05:22
Most of 48h tests are done in the NICU where babies stay longer. Some in NBN get 48h but not all
Megan Aurora
01:05:43
support people need to wear masks and perform hand hygiene prior to touching infant when staying in mother’s room
Cyrus Yau
01:06:36
ok thanks for the response
Lucienne's iPad
01:06:52
Regarding NP swab in newborns _ is there a recommendation to obtain over 5 min?
Lindsay Fox
01:06:55
Is dad staying in mom’s room? going back and forth to care for baby?
Megan Aurora
01:07:40
NP swabs, 5 sec in each nares
ivanaculic
01:08:54
great idea Munish.
Cathleen Renzi
01:09:24
Is anyone else seeing telemedicine being used for low risk newborn visits?
nicolerandazzo-ahern
01:09:47
Other than MGH?
Lucienne's iPad
01:09:51
Thx - we have a typo in our protocol which says 5 min!! :-)
Meg ParKer
01:10:10
At BMC we don’t call them, but nearly all go to our own center or community health centers…
Munish Gupta
01:10:41
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.
Cathleen Renzi
01:11:52
Yes. Other than MGH. Just trying to get a feel for how common it is.
kellehma
01:12:33
What if you have more than one baby in the nursery?
TERRI GORMAN
01:13:54
The nursery is large enough to have several cribs separated by > 6 feet with PPE for all caregivers or well caregivers.
Sanjay Aurora
01:14:02
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
Kate MacMillan
01:15:18
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 .
nicolerandazzo-ahern
01:15:55
All of partners universal
asekelsky
01:16:00
We are not here at Anna Jaques Hospital. Until it changes!
Mario Cordova
01:16:10
At Lowell General, we are testing 48-72 hours prior to scheduled IOL or CS. Not universal for all mothers.
Leela Sarathy
01:16:24
Steward is screening all Moms at 38 weeks... or rapid test on admission if hasn't been done
H. Ozlem Kasaroglu
01:16:43
Brockton universal
Laura Federico
01:16:57
Lawrence universal
Lindsay Fox
01:17:10
MWMC- going universal any minute
Munish Gupta
01:17:56
BIDMC is targeted testing, although they are considering universal. Rapid availability of results is an important consideration!
Leela Sarathy
01:18:13
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)
Sanjay Aurora
01:18:24
UMass is targeted currently. Might change
Meg ParKer
01:18:36
I can share a bunch of lactation resources.
Marie's iPad
01:19:04
there is one list at MGH for Covid positive mothers that is followed by 2 triage nurse and one MFM daily.
Megan Aurora
01:19:32
How does the support person get masks for discharge? you using face coverings?
Jessica Ninomiya
01:20:03
Targeted at Beverly Hospital. LOVE the ideas about testing everyone at 38 weeks and/or 72 hours prior to scheduled IOLs and C/S!!!
nicolerandazzo-ahern
01:20:29
MGH has it as well! Yep
Marie's iPad
01:20:38
this is a work in progress at MGH. the patient is given one hospital grade mask.
Leela Sarathy
01:21:52
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
nicolerandazzo-ahern
01:22:13
Leela- I can share MGH one
Leela Sarathy
01:22:21
Thank you!
Zuzanna Kubicka SSH/BCH
01:22:22
Handout would be great!
Laura Federico
01:22:30
Lawrence is giving cotton masks to our mothers on discharge
Cyrus Yau
01:22:36
thanks everyone.
Cyrus Yau
01:22:43
great presentations
Cathleen Renzi
01:23:03
The health dept in Lowell has been helpful with acquiring PPE for covid + families at discharge.
Meg ParKer
01:24:17
At BMC we have had 13 COVID + mothers deliver, 5 + babies and all babies are healthy
Megan Aurora
01:24:54
Meg, are more details about those 5 babies available to share?
Ann Velie
01:24:55
Meg, are you thinking those 5 are vertical or horizontal?
Jessica Ninomiya
01:25:04
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.
Meg ParKer
01:25:12
combo- some occurred with strict separation and some with rooming in
Megan Aurora
01:25:26
c-section vs vaginal deliveries?
Ann Velie
01:25:47
was the infant positive at 24hrs separated from birth?
Marianne Anderson
01:25:52
Thank you everyone!!! This has been excellent.
Meg Parker
01:26:18
I am here but computer died.
Meg Parker
01:26:34
had to go to a different one
Meg Parker
01:26:42
can you unmute me?
Meg Parker
01:27:52
No problem! see you all next time
Tanzeema H
01:27:58
Thank you!
Sherman & Nasim (UMass)
01:28:08
Thanks!