We report a 3½-month-old infant with trisomy 21 presenting with galactorrhea in the neonatal intensive care unit (NICU). Endocrine work-up showed a high prolactin level (64.4 ng ml À1 Fnormal: 0.5 to 30 ng ml À1 ). Cessation of therapy with metoclopramide (0.2 mg kg À1 per dose q 6 h) resulted in the resolution of galactorrhea with a decrease in serum prolactin level (20.1 ng ml À1 ). We present this case to highlight this uncommon side effect of a commonly used medication in the NICU.

AimThere are different guidelines to calculate red blood cell (RBC) replacement volume in neonates, ranging from 5 ml/kg up to 20 ml/kg RBC volume to be transfused. We aimed to investigate which method is more reliable in achieving the desired Haemoglobin (Hb) from a single blood transfusion in infants<32 weeks gestation admitted to the Neonatal Intensive Care Unit (NICU).MethodsPreterm infants<32 weeks gestations were enrolled if they were admitted to the Neonatal Intensive Care Unit, required a RBC transfusion and parental consent was obtained. Infants were excluded if there was evidence of active bleeding, intraventricular haemorrhage (IVH) grade ≥III or more at the time of transfusion,<24 hours post surgical intervention, ABO/Rh incompatibility or Disseminated Intravascular Coagulopathy. Each infant was then randomised to either the standard practice of calculating RBC volume (RBC volume=20 ml/kg) or to the intervention volume calculation (RBC volume=5×working weight × [Hb desired – Hb current]).ResultsSixty three infants were randomised, 55 infants had values for both the post-transfusion Hb and the target Hb. A chi-square test was used to determine if there was an association between the group to which the infant was randomised and whether they achieved the target Hb level. 21 (84.0%) of the 25 infants in the control group achieved the target Hb level, and 20 (66.7%) of the 30 infants in the intervention group achieved the target Hb level. Testing at a 5% significance level, there is no significant difference between the control and intervention groups in the proportion of infants who achieved the target Hb level (p=0.142, df=1).ConclusionThere was no significant difference between the 2 methods of RBC volume calculation in achieving the target Hb. The simpler calculation method of 20 ml/kg may be the optimum method as less chance of calculation error.

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Aims Communication between parents/carers and healthcare providers in a setting of neonatal intensive care unit is crucial to reduce their emotional stress, help in decision making, engaging them in active care, while building trust and confidence in the health care services provided. To implement a family centred care in neonatal units, the feedback from parents is essential to improve the quality of healthcare services provided.The study will determine the potential factors, that may improve communication between parents/carers and the healthcare service providers, during the stay of their new-born babies at the Neonatal intensive care unit. Methods Methodology A Parent's experience survey Questionnaire was prepared to determine the objectives of the study. The questionnaire included various domains including 'interaction with doctors and nurses', 'knowledge and information sharing', 'active care and pro breast-feeding strategies', 'empowered decision making', 'co-ordinated discharge planning', and 'trust and confidence in doctors and nurses. The relevant domains were answered as 'YES or 'NO' with a further grading on a scale from 1 to 5, where 1 is poor, 2 is Fair, 3 is good, 4 is very good and 5 is excellent. The questionnaire included a separate section for comments to provide any additional information, deeming necessary to improve communication. The paper-based questionnaire was completed by the parents/carers at the time of discharge by themselves, or via a telephone call where the healthcare service provider read the questionnaire for the parents/carers while noting their answers accordingly, or by reading the questionnaire to the parents/carers in a face-to-face session. The eligible study population included the neonates admitted in NICU from the period of July to October 2021 and their parents who were randomly selected. An informed consent was taken prior to be included in the study. A total of 30 questionnaires were collected. The collected data was gathered on an excel sheet and results were formulated via the same. Results On evaluation of results we found, 90% responded excellent for trust and confidence with doctors and nurses, 93% responded excellent for coordinated discharge planning, 70% responded excellent for knowledge, information sharing and interaction with health care providers, 60% responded excellent and 17% responded good for empowered decision making.53% responded excellent 10% good for active care, 53% responded excellent and 11% responded fair for privacy for breast feeding. Some innovative thoughts and positive comments were noted from parents. Conclusion Our study concluded that most of the domains in communication were practiced appropriately in our unit predominantly for trust, knowledge information sharing and coordinated discharge plans. However, implementation of better facilities is required to improve privacy for breast feeding. Continuous medical education should be provided for all the staff members to enhance our communication skills while addressing the emotional and ...

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RESULTS: VHI has been used on 10 patients(median age 13) with positive outcomes: effective secretion clearance(10), improved ventilation/oxygenation(5), auscultation changes(8), CXR resolution(6) with no adverse events. VHI transitioned to a physio initiated and led technique with clear indicators and criteria for use. CONCLUSIONS:VHI was found to be able to be safely and effectively used in paediatric patients using modified adult protocols and successfully implemented within the PICU.