It probably means that it is a false fact (you have torn into Wharton's jelly if there is strong resistance. It is normal to have some very mild resistance that you push through. Best is to take out and try again turning the catheter to different directions. If that doesn't work, you can cut the cord a little closer to the base and look for the vessels again. Best of luck!
Hi, I am a neonatologist here in Brazil and I was very pleased to attend this class. For me, it was inspiring. I work with residents and was excited to be able to create content like yours. Congratulations for the excellent work. It would be a pleasure to meet you in person. Regarding the materials and mannequin, could you tell me where I have access? Thanks! Rodrigo
Muito obrigado! I thank you for your kind comment. From a beautiful country like Brazil. I hope to visit one day! Being from Perú, I always looked up to Brazil "futebol" and the "jogo bonito." 😁. The baby is a simulator from the following company called Preemie Paul. simcharacters.com/en/products/paul/ I have met the inventors who are a German couple of neonatologists. Really great simulator (can be expensive..but worth it to teach).
@@thenicudoc Thank you very much for replying! I work with a Peruvian neonatologist friend. I will access the site and get to know Paul better. I hope that one day I can get to know Brazil, its natural beauties and the wonderful people here.
Thanks for your video. In our practice, the umbilical cord will contract back into the abdomen in few days, and so as the catheter. It causes the placement to be deeper. How can this be resolved?
はじめまして. One thing to avoid is pulling on the umbilical cord when placing it. If you pull on it, then it will retract when you finish the procedure. Best to not put any tension. If you still find this to be a problem, you can make your insertion length calculation and then subtract 0.5 and obtain an XRAY the next day to ensure it did not go too deep. 頑張ってください
Excellent video! I just don’t see why the recent guidelines say this is the access of choice during neonatal reanimation. Especially for someone who does not do at least a couple of these a year.
To be honest, it is fairly easy to do if you can do a simulation to keep up your skills. Also, Wharton Jelly (where the umbilical cord is) does not have any nerve cells so it is painless. Finally, it is a big vessel and central, you can give large volumes and strong co centrated drugs. Something that can be limiting or dangerous with just a PIV.
After you insert and fix that line, is there any procedure like cleaning the area and just pack that area with sterile packing and tape so we can avoid accidental pulling of Catheter while giving drugs and iv fluids??
Great question. You definitely want to clean the solution off you used to sterilize the skin for the procedure. Then you cover the lines with tegaderm or other film or tape against the abdomen so the infant doesn't tangle and accidentally pull the line. Correct!
Hii Dr Ravindra here... Nice explanation... Especially stabilization of uvc, here I have one problem which comes every time that after stabilization, there is some blood spillage is there in upcoming hours and we have to apply pressure gauge pieces to stop it ... Can you please suggest some solution for the same... Thank you 😊
Umm..if I am understanding, this is a few hours after placing the lines? Maybe keep the umbilical tie around the base (just cut it a little shorter) and add some tension so that you have it helps to hold any bleeding in check (like the pressure you are putting with the gauze). Hope this helps.
If I knew...it wouldn't happen to me either 😁. All the little tricks they tell you is just that...tricks. A lot of it is anatomy and luck. Don't get frustrated
Yes. Thank you for bringing this up. The objective of this video was insertion and stabilizing the catheter. Steps after this would be to clean off any cleaning solution on the skin and place a dressing to keep the area as clean and sterile as possible.
Hello sir....how can we avoid UVC line to migrate in portal vein
Thank you for the great illustration.
What to do when I face resistance during insertion of cath ?????
It probably means that it is a false fact (you have torn into Wharton's jelly if there is strong resistance. It is normal to have some very mild resistance that you push through. Best is to take out and try again turning the catheter to different directions. If that doesn't work, you can cut the cord a little closer to the base and look for the vessels again. Best of luck!
@@thenicudoc thank you soo much
Perfect. Thanks a lot
Good explanation and let you share presentation slide
Loved the info and Thank you for the Mom thought to “clean up!” Us nurses really appreciate it!😊
LOL! You guys work real hard...we don't need to add your already busy day.
At the end do you remove the umbilical ție or not?
Thank you for your answer!
I cut the tie and leave 1cm ends. That way, when I remove the line, I have the tie just in case the umbilicus would start bleeding.
@@thenicudoc thank you!
Hi, I am a neonatologist here in Brazil and I was very pleased to attend this class. For me, it was inspiring. I work with residents and was excited to be able to create content like yours. Congratulations for the excellent work. It would be a pleasure to meet you in person. Regarding the materials and mannequin, could you tell me where I have access? Thanks! Rodrigo
Muito obrigado! I thank you for your kind comment. From a beautiful country like Brazil. I hope to visit one day! Being from Perú, I always looked up to Brazil "futebol" and the "jogo bonito." 😁. The baby is a simulator from the following company called Preemie Paul.
simcharacters.com/en/products/paul/
I have met the inventors who are a German couple of neonatologists. Really great simulator (can be expensive..but worth it to teach).
@@thenicudoc Thank you very much for replying! I work with a Peruvian neonatologist friend. I will access the site and get to know Paul better. I hope that one day I can get to know Brazil, its natural beauties and the wonderful people here.
Great explanation. Thank you
I am so glad you liked. Thanks for taking the time to comment
Thanks for your video. In our practice, the umbilical cord will contract back into the abdomen in few days, and so as the catheter. It causes the placement to be deeper. How can this be resolved?
はじめまして. One thing to avoid is pulling on the umbilical cord when placing it. If you pull on it, then it will retract when you finish the procedure. Best to not put any tension. If you still find this to be a problem, you can make your insertion length calculation and then subtract 0.5 and obtain an XRAY the next day to ensure it did not go too deep.
頑張ってください
Thanks
Very interesting
Glad you found it so.
1/2 of the UAC or UVC plus 1 for UAC?
1/2 of the UAC length + 1 for the UVC length of insertion (UAC length is always the longer one)
Thanks from Egypt
you so welcome...from the U.S. And I will visit Egypt one day!
Excellent video!
I just don’t see why the recent guidelines say this is the access of choice during neonatal reanimation. Especially for someone who does not do at least a couple of these a year.
To be honest, it is fairly easy to do if you can do a simulation to keep up your skills. Also, Wharton Jelly (where the umbilical cord is) does not have any nerve cells so it is painless. Finally, it is a big vessel and central, you can give large volumes and strong co centrated drugs. Something that can be limiting or dangerous with just a PIV.
After you insert and fix that line, is there any procedure like cleaning the area and just pack that area with sterile packing and tape so we can avoid accidental pulling of Catheter while giving drugs and iv fluids??
Great question. You definitely want to clean the solution off you used to sterilize the skin for the procedure. Then you cover the lines with tegaderm or other film or tape against the abdomen so the infant doesn't tangle and accidentally pull the line. Correct!
best explaination 👌🏻
thank you for that wonderful feedback 😊
Hii Dr Ravindra here... Nice explanation... Especially stabilization of uvc, here I have one problem which comes every time that after stabilization, there is some blood spillage is there in upcoming hours and we have to apply pressure gauge pieces to stop it ... Can you please suggest some solution for the same... Thank you 😊
Umm..if I am understanding, this is a few hours after placing the lines? Maybe keep the umbilical tie around the base (just cut it a little shorter) and add some tension so that you have it helps to hold any bleeding in check (like the pressure you are putting with the gauze). Hope this helps.
thanks 🙏🙏🙏
Glad you liked 😊
How to avoid incorrect placement in liver
If I knew...it wouldn't happen to me either 😁. All the little tricks they tell you is just that...tricks. A lot of it is anatomy and luck. Don't get frustrated
Sir u didn’t mention dressing after placing sutures. Is it necessary or not ??
Yes. Thank you for bringing this up. The objective of this video was insertion and stabilizing the catheter. Steps after this would be to clean off any cleaning solution on the skin and place a dressing to keep the area as clean and sterile as possible.
The cord on manikin is unrealistically long. It would be cut shorter with clamp
For illustration purposes...a lot was not done here hahahahha