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The S.T.A.B.L.E. Program. Post-resuscitation / Pre-transport Stabilization Care for Sick Infants. Guidelines for Neonatal Healthcare Providers – 6th edition. Kristine A. Karlsen. Instructor Manual.
This educational program provides general guidelines for the assessment and stabilization of sick infants in the post-resuscitation / pre-transport stabilization period. These guidelines are based upon evidence-based recommendations in neonatal texts and published literature whenever possible. When necessary, common neonatal stabilization care practices were evaluated and incorporated into this program. Changes in infant care may impact the recommendations contained in this program; such changes should be assessed on a regular basis. While caring for sick infants, healthcare providers may encounter situations, conditions, and illnesses not described in this manual. It is strongly recommended that additional nursing and medical education materials and consultation with neonatal experts are utilized as necessary. Prior to implementing these program guidelines, the content of this manual should be reviewed and approved for use by appropriate policy committees at your institution or facility.
- An excellent printed book
- Format 22.8 x 28 x 3.5 cm
- 326 pages printed in full color
- Fine spiral binding
- Sixth edition, year 2013
- ISBN-10: 1-937967-03-4, 1937967034
- ISBN-13: 978-1-937967-03-1, 9781937967031
- Author: Kristine A. Karlsen
- © American Academy of Pediatrics
Blood Gas Values, ET Tube Sizes, Initial Ventilator Support.
INSTRUCTOR MANUAL.
About the S.T.A.B.LE. Program.
Program Development.
Course Format: Didactic-Interactive or Self-Study.
Who Should Participate in S.T.A.B.L.E.?
How Long Does it Take to Administer the Learner Course?
How to Use the Instructor Manual.
S.T.A.B.L.E. Program Components.
Pre- and Post-Testing and Quizzes Embedded in the Modules.
Equipment Needed for Program Presentation.
How to Order Program Materials.
Beginning the S.T.A.B.L.E. Program Presentation.
Using Adobe® Flash Software.
Simulation and the Neonatal Stabilization Scenarios.
Suggested Time-Line: One-Day Learner Course Presentation.
Frequently Asked Questions from Lead Instructors
LEARNER MANUAL.
Blood Gas Values, ET tube sizes, Initial Ventilator Support.
Program Philosophy
Program Goals.
Newborn Transport.
The S.T.A.B.L.E. Mnemonic.
The ABCs.
Module One SUGAR and SAFE CARE.
Sugar and Safe Care Module Objectives.
Safe Patient Care.
Sugar - General Guidelines.
Preparation for Extrauterine Life and Factors that Affect Glucose Stability after Birth.
Glucose Monitoring.
Signs and Symptoms of Hypoglycemia.
Recommended Target Blood Sugar for Infants Who Require Neonatal Intensive Care.
Initial IV Fluid and Rate.
Umbilical Catheters.
Safe Use of Umbilical Catheters.
Additional Information for Neonatal Intensive Care Unit (NICU) Staff.
Appendix 1.1 Bowel Obstruction.
Appendix 1.2 Intrauterine Growth Curves: Female.
Appendix 1.3 Intrauterine Growth Curves: Male.
Appendix 1.4 Dextrose Preparation Chart for IV Infusion.
Appendix 1.5 Calculating Umbilical Catheter Depth Using Mathematical Formulas.
Appendix 1.6 Determining Umbilical Catheter Tip Location Using a Graph.
Sugar Module References.
Module Two TEMPERATURE.
Temperature Module Objectives.
Introduction.
Key Concepts.
Temperature and Effect on Metabolic Rate and Oxygen Consumption.
Detrimental Effects of Hypothermia: Term and Preterm Infants.
Detrimental Effects of Hypothermia.
Mechanisms of Heat Loss.
Terapeutic / Neuroprotective Hypothermia to Treat Hypoxic-Ischemic Encephalopathy (HIE).
Candidacy for Therapeutic / Neuroprotective Hypothermia Checklist.
Neurological Exam to Evaluate Candidacy for Therapeutic/ Neuroprotective Hypothermia.
Rewarming the Hypothermic Infant after Unintentional (accidental) Hypothermia.
Temperature Module References.
Module Three AIRWAY.
Airway Module Objectives.
Airway - General Guidelines.
Patient Evaluation and Monitoring.
Respiratory Distress Evaluation.
Respiratory Rate.
Increased Work of Breathing.
Oxygen Saturation.
Oxygen Requirement.
Blood Gas Evaluation.
Blood Gas Interpretation Using a Modified Acid-Base Alignment Nomogram and S.T.A.B.L.E. Blood Gas Rules©.
Respiratory Support.
Continuos Positive Airway Pressure (CPAP).
Positive Pressure Ventilation with Bag and Mask or T-piece Resuscitator.
Endotracheal Intubation.
Assisting with Endotracheal Intubation.
Securing the Endotracheal Tube.
Location of the Endotracheal Tube on Chest X-ray.
Neonatal Respiratory Illnesses.
Airway Obstruction.
Persistent Pulmonary Hypertension of the Newborn.
Pneumothorax.
Pain Control with Analgesics.
Appendix 3.1 Practice Session: Blood Gas Interpretation.
Appendix 3.2 Neonatal Respiratory Diseases: TEF/EA, CDH, PPHN.
Airway Module References.
Module Four BLOOD PRESSURE.
Blood Pressure Module Objectives.
What is Shock?
Cardiac Output.
Blood Pressure.
The Three Types of Shock: Hypovolemic, Cardiogenic, Septic.
Treatment of Shock.
Medications Used to Treat Cardiogenic and Septic Shock.
Dopamine Dosing for Newborns.
Rules for Dopamine Infusion.
Appendix 4.1 Scalp Swellings: Caput Succedaneum, Cephalohematoma, Subgaleal Hemorrhage.
Appendix 4.2 It Isn’t Just the Lungs: A Case Presentation.
Blood Pressure Module References.
Module Five LAB WORK.
Lab Work Module Objectives.
Lab Work - General Guidelines.
Neonatal Infection.
Laboratory Evaluation.
Laboratory Tests to Obtain After Transport.
Complete Blood Count (CBC) Interpretation.
Initial Antibiotic Therapy for Sick Infants.
Appendix 5.1 Evaluation of Asymptomatic Infants < 37 Weeks’ Gestation with Risk Factors for Sepsis.
Appendix 5.2 Evaluation of Asymptomatic Infants ≥ 37 Weeks’ Gestation with Risk Factors for Sepsis.
Appendix 5.3 Evaluation of Asymptomatic Infants ≥ 37 Weeks’ Gestation with Risk Factors for Sepsis (No Chorioamnionitis).
Appendix 5.4 Algorithm for Secondary Prevention of Early-Onset Group B Streptococcal Disease Among Newborns.
Appendix 5.5 Indications and Nonindications for Intrapartum Antibiotic Prophylaxis to Prevent Early-Onset Group B Streptococcal (GBS) Disease.
Appendix 5.6 Algorithm for Screening for Group B Streptococcal (GBS) Colonization and Use of Intrapartum Prophylaxis for Women with Preterm Labor (PTL).
Appendix 5.7 Algorithm for Screening for Group B Streptococcal (GBS) Colonization and Use of Intrapartum Prophylaxis for Women with Preterm Premature Rupture of Membranes (PROM).
Appendix 5.8 Recommended Regimens for Intrapartum Antibiotic Prophylaxis for Prevention of Early-Onset Group B Streptococcal (GBS) Disease.
Appendix 5.9 Hematologic Reference Ranges.
Case Study: Baby Smith.
Practice Session: Lab Work.
Lab Work Module References.
Module Six EMOTIONAL SUPPORT.
Emotional Support Module Objectives.
Introduction.
Helpful Ideas for When the Infant Requires Transport.
Appendix 6.1 Providing Relationship-Based Care to Babies and Their Parents.
Emotional Support References.
Module Seven Quality Improvement.
Introduction.
The Importance of Teamwork and Team Training.
Simple, Standardized, Processes of Care: The S.T.A.B.L.E. Program.
Pre-Transport Stabilization Self-Assessment Tool (PSSAT).
Quality Improvement References.
Procedures.
Peripheral IV Insertion and Taping the IV.
Positive Pressure Ventilation with Bag and Mask or T-Piece Resuscitator.
Endotracheal Intubation: Assisting, Verifying Placement and Securing ET Tube.
Umbilical Venous Catheter insertion.
Umbilical Artery Catheter Insertion.
Pneumothorax Evacuation: Needle Aspiration of the Chest.
Pneumothorax Evacuation: Chest Tube Insertion.
Index.
Pound to Gram Conversion Chart.
°C to °F Temperature Conversion Chart.
