I work in a small community hospital as an LDRP nurse and we seem to be seeing more and more pregnant women with uncontrolled diabetes. This was so helpful to explain the “why” of a number of issues we see with these babies. I appreciate your ability to convey information in easy to understand terms.
Hello- we're so glad this has been helpful all! Thanks so much for taking the time let us know. Also- so impressive you're looking for education in alternative places- on like a NICU youtube channel. Says a lot more about you than about us!!! Thank you :)
This was so informative from a respiratory standpoint!! This week alone I had two 35 weekers come out in respiratory distress one needed needle aspirated and surfed. Thanks for helping understand why!
Hello! We haven’t made a C-section video- I’m assuming you meant from a neonatal standpoint! Honestly when OBs are doing a C-section it’s normally to save the baby or save the mama (or better for either for some reason) and so most of the time we have to deal with it!!!!
Yes! This is a great idea for a quick video! Essentially- it is encouraged in units that have more fungal infections. We can definitely cover that. Thanks for that idea!!!
Hi Dr Tala, Is it possible to do videos on osteopenia in preterm and at what stage does low phosphate is concern a GI issue, chest and abdominal X-rays please.All your videos are very informative.
Hi Cecile- this is a great idea. It's funny- when I was in residency- we had so many issues with osteopenia (and alkaline phosphatase >1000, with poor little babies getting fractures)- now we're all so much better with nutrition, and we have much better choices, that it's much rarer. But it is a very important topic- especially since we're still on a fluid and electrolyte kick!
You are so right! We made this video a couple of years ago and have since realized how we need to be including so many more pictures and graphics. Slightly improving but we still have a ways to go!!!! Thank you!
Hello!I'm assuming you're referring to congenital hyperinsulinism? (This used to be called nesidioblastosis)- and it's basically a 'tumor' of the islet cells in the pancreas- that continuously over-secret insulin. (So unlike the normal IDM neonate- the hyperinsulism is transient- with CHI- the high insulin levels never go away). Many of these are genetic in origin. Ultimately they are treated with aggressive feeds (if milder), medications and sometimes surgery- where a large part of the pancreas is removed. (We will cover a video on hypoglycemia at some point!) Thanks foe asking this question :)
Thank you so much for the rich and smooth videos you do on this channel. Back in the late 90s while going through my neonatology training at LLUCH , we were instructed to check G.S q 15 minutes in the first 4 hours , especially in mother with poorly controlled blood sugar . i wonder if you can give standard protocol for such situation ? currently i go with q 1/2 hour in the first 4 hours ! thanks
Hello! So glad you like the videos. So generally the only babies we check for sugars are the ones at risk (SGA, LGA, IDM and premature). Protocols are pretty much set by different hospitals. Generally, the first sugar is checked soon after birth ~1 hr. Even the threshold for hypoglycemia is different in different hospitals (somewhere around < 45). If sugars are normal then they're checked qAC for 12- 24 hrs. If abnormal- then a different pathway followed- we use glucose gel if needed. Does that help?!
Yes- probably should have emphasized that more. Definitely a higher risk of developing PPHN (RDS, perinatal depression, septal hypertrophy). We look back at so many of these videos and think how we could have improved upon them! We're constantly trying!! Thank you!
OMG I wasn't aware insulin can't cross the placenta. I kept thinking it was maternal insulin that accumulated in the child (baby+ mom's insulin maybe had an added action) and needed a day or two to be used up and then the baby would be okay. Thank you for this really informative video!
Dr Tala, when we monitor BSR in an IDM, do we screen for the first 48 hours at hours 0, 2, 4, 6, 12, 24, and 48? Is this the recommendation? We follow this, but sometimes we also follow 2 hourly monitoring (and then relax to 4 hourly blood sugars if they are satisfactory) so I don't know why we have different approaches? Thank you, Dr Tala
Hello! Excellent question! Each hospital has slightly different protocols- so there really isn’t a standard. Generally sugars are checked before feedings (so we have the lowest possible sugars). So normally this is ~ q 3 hrs. There is so much controversy about which sugar levels are acceptable and what to do about it that I’m guessing every protocol is within standard of care. I wouldn’t be surprised if we all decrease how often we’re checking sugars in asymptomatic neonates in the near future.
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I work in a small community hospital as an LDRP nurse and we seem to be seeing more and more pregnant women with uncontrolled diabetes. This was so helpful to explain the “why” of a number of issues we see with these babies. I appreciate your ability to convey information in easy to understand terms.
Hello- we're so glad this has been helpful all! Thanks so much for taking the time let us know. Also- so impressive you're looking for education in alternative places- on like a NICU youtube channel. Says a lot more about you than about us!!! Thank you :)
It was one of the best videos I've ever watched during med school. Thank you so much!
Wow! Thank you! That comment made our day!!!! Please check out the other ones and let us know if there are any videos you’d be interested in?!
This was so informative from a respiratory standpoint!! This week alone I had two 35 weekers come out in respiratory distress one needed needle aspirated and surfed. Thanks for helping understand why!
Crazy how they come in pairs and theres- always! So glad you found this helpful!
Thanks for this. Take my OB final in 2 weeks. lets go!!
Oh yay! Good luck!!!! Thanks for writing to us!!!
Your lectures are a gem!!
Thank you so much!!!
CAN WE HAVE VEDIO FOR HYPOGLYCEMIA APROACH
THANK YOU SO MUCH FOR YOUR AMAZING EXIPLANATION
Ok I think we’ll try to do this one next!!! It’s time!!!!! Thanks for being here!
Amazing presentation , i enjoy your lectures. Watching you from zambia-AFRICA
That makes us so happy! Thank you for watching and thank you for letting us know where you are! We imagine beautiful views from your NICU!!
Clear, concise and very informative. Thank you
Thanks so much Mercy for your lovely words. We really appreciate you being here :)
Thank you Dr tala for explaining ❤
My pleasure 😊thank you for being here!
This was soooooooooooo helpful!
Sooooooooo happy you found it helpful!! Ha! Thanks for being here :)
could you make a video regarding drawbacks of c- section..
if you already has one, please provide the link.
thanks
Hello! We haven’t made a C-section video- I’m assuming you meant from a neonatal standpoint! Honestly when OBs are doing a C-section it’s normally to save the baby or save the mama (or better for either for some reason) and so most of the time we have to deal with it!!!!
Thank you very much for this wonderful discussion. This is really a great help to me.
Love the way you expound the topic/s.
We're so happy you found this video helpful. Thank you so much for taking the time to write to us :)
Could you please give presentation on prophylaxis fluconazole in extreme low birth weight baby
Yes! This is a great idea for a quick video! Essentially- it is encouraged in units that have more fungal infections. We can definitely cover that. Thanks for that idea!!!
Awesome as always Dr. Tala!!!
We always love your comments! Thanks so much for your continued support :)
Hi Dr Tala,
Is it possible to do videos on osteopenia in preterm and at what stage does low phosphate is concern a GI issue, chest and abdominal X-rays please.All your videos are very informative.
Hi Cecile- this is a great idea. It's funny- when I was in residency- we had so many issues with osteopenia (and alkaline phosphatase >1000, with poor little babies getting fractures)- now we're all so much better with nutrition, and we have much better choices, that it's much rarer. But it is a very important topic- especially since we're still on a fluid and electrolyte kick!
Excellent work...But images and graphics will make presentation much tastier....Anyway excellent job
You are so right! We made this video a couple of years ago and have since realized how we need to be including so many more pictures and graphics. Slightly improving but we still have a ways to go!!!! Thank you!
Can you cover eclampsia and preeclampsia?
Yes! We’re planning on this video soon! Thanks so much for the suggestion!
Thank you doctor for your explanation.
Thank you for watching Kebede!
good presentation
Thank you!!!!
Very commanding talk Dr Tala
Thank you so much for continuing to watch our channel!!! We appreciate your support :)
Hi Dr Tala
Is it possible to explain the pathophysiology of CHI please.
Hello!I'm assuming you're referring to congenital hyperinsulinism? (This used to be called nesidioblastosis)- and it's basically a 'tumor' of the islet cells in the pancreas- that continuously over-secret insulin. (So unlike the normal IDM neonate- the hyperinsulism is transient- with CHI- the high insulin levels never go away). Many of these are genetic in origin. Ultimately they are treated with aggressive feeds (if milder), medications and sometimes surgery- where a large part of the pancreas is removed.
(We will cover a video on hypoglycemia at some point!)
Thanks foe asking this question :)
Thank you Dr. Tala! God Bless you!
Thank you for the lovely sentiment Bernadette! We really appreciate you being here :)
Very nice presentation 👍👍
Thank you so much
Thank you so much for watching and for taking the time to comment Eyad :)
Thank you so much for the rich and smooth videos you do on this channel. Back in the late 90s while going through my neonatology training at LLUCH , we were instructed to check G.S q 15 minutes in the first 4 hours , especially in mother with poorly controlled blood sugar . i wonder if you can give standard protocol for such situation ? currently i go with q 1/2 hour in the first 4 hours ! thanks
Hello! So glad you like the videos. So generally the only babies we check for sugars are the ones at risk (SGA, LGA, IDM and premature). Protocols are pretty much set by different hospitals. Generally, the first sugar is checked soon after birth ~1 hr. Even the threshold for hypoglycemia is different in different hospitals (somewhere around < 45). If sugars are normal then they're checked qAC for 12- 24 hrs. If abnormal- then a different pathway followed- we use glucose gel if needed. Does that help?!
Wow that was a lot. Nicely done!
Thank you Joey- and again- thanks for subscribing!
Very useful information
So glad you think so- thank you!
Very veryy well explained
Thank you so much :)
Amazing videos....i do recommend
Thank you- we appreciate your support!
thanks alot but why you dont talk about PpHn in idm
Yes- probably should have emphasized that more. Definitely a higher risk of developing PPHN (RDS, perinatal depression, septal hypertrophy). We look back at so many of these videos and think how we could have improved upon them! We're constantly trying!! Thank you!
Very informative Doc. Thank you so much for this:)
Thank you for watching and taking the time to thank us!!
well explained
Thank you so much!!
Great very informative
We're so glad you found it informative. Thanks so much for being here Syed :)
Love this easy explanation. Will surely share this video to my nicu nurses 👍
Thank you so much Beverly! You've been such a loyal supporter :)
OMG I wasn't aware insulin can't cross the placenta. I kept thinking it was maternal insulin that accumulated in the child (baby+ mom's insulin maybe had an added action) and needed a day or two to be used up and then the baby would be okay. Thank you for this really informative video!
So glad it helped! Love those a- ha moments!!!
@@TalaTalksNICU yes!!!
Blesss u 😊
Thank you :))))
Thank you!
Thank you so much for watching and commenting :)
Amazing 👏👏
Thank you so much! And thanks so much for subscribing Minhaj :)
thank you
Thank you so much for watching (and for subscribing!)!!
Thank you very much
Thank you so much for watching and for taking the time to comment :)
Thanks
Thank you for watching :)
Nice video
We're so glad you liked it Sumathy! Thanks for letting us know :)
Thank you 🙏🏼
You're so welcome- thanks for being here :)
Thank you doctor
Thank you so much for watching and for taking the time to comment :)
Dr Tala, when we monitor BSR in an IDM, do we screen for the first 48 hours at hours 0, 2, 4, 6, 12, 24, and 48? Is this the recommendation? We follow this, but sometimes we also follow 2 hourly monitoring (and then relax to 4 hourly blood sugars if they are satisfactory) so I don't know why we have different approaches? Thank you, Dr Tala
Hello! Excellent question! Each hospital has slightly different protocols- so there really isn’t a standard. Generally sugars are checked before feedings (so we have the lowest possible sugars). So normally this is ~ q 3 hrs. There is so much controversy about which sugar levels are acceptable and what to do about it that I’m guessing every protocol is within standard of care. I wouldn’t be surprised if we all decrease how often we’re checking sugars in asymptomatic neonates in the near future.
👌👏
Thank you!!!
Sorry l meant consider a Gl issue.
Yes- this is great too- we're going to start a 'symptom' type series- so we'll cover this then too. Thanks for being here!