Night round

At around 9pm we reviewed a couple of neonates.  Dr Francis had been called out of the morning service to attend to a lady with a “face presentation” where the baby’s head had not flexed properly for delivery.

Hanna went up to check how things were going and noted another baby having fits.  Sadly this was a case of prolonged labour where the baby had required resuscitation.  Hanna gave the baby intravenous phenobarbitone with some benefit but there was still some abnormal movement so a dose of diazepam was administered.  On review the baby is much more settled, on fluid restriction and covered with antibiotics.

Whilst reviewing this baby we noted a new admission baby having oxygen.  We were able to take the baby out of oxygen having checked the oxygen saturation.  This measurement is a really useful assessment that has become completely routine in UK.

In the photo Ian is using a new portable oxygen saturation monitor purchased with generous donations from colleagues at Macclesfield District General Hospital paediatric and neonatal units.  We are very grateful for this support.  Hanna has arranged for our carpenters to make a small box to house the monitor to provide support for the connection between the sensor wire and the monitor itself.  This junction can be easily damaged with frequent use making the device unusable which would be very frustrating. 

The photo also shows an oxygen concentrator which provides a flow of about 92% oxygen.  This equipment is very appropriate here as it only needs room air and electricity and can run for years.  The alternative of cylinder oxygen is both expensive and impractical.  Cylinders have to be obtained in Kampala which is a long trip, and don’t last long anyway.

You will also notice a couple of incubators in the photo.  Generally its better to keep babies with their mums and to use an approach called "kangaroo care".  However the advantage in this situation with incubators is to have the babies visible so their condition can be monitored easily. These incubators are situated in what is really a corridor so a fairly limited space.  At some time in the future we hope for a proper special care baby unit layout.

However, the challenge of maintenance applies to all these devices and the Hospital Management are looking at how to improve this.