The Incubator

Send us a textIn this Tech Tuesday episode of the Incubator podcast, Ben and Daphna engage in an enlightening conversation with Dr. Shama Patel, a neonatologist and clinical informaticist at Nationwide Children's Hospital. Dr. Patel sheds light on the pressing issues surrounding electronic medical record (EMR) systems and documentation practices in neonatology. She addresses the problem of "note bloat," where progress notes become excessively long and filled with redundant information, contributing to physician burnout and potential errors in patient care. Dr. Patel shares her innovative work in creating a more efficient and relevant patient review screen in Epic, tailored explicitly for neonatology, and discusses the development of a new progress note template aimed at reducing documentation burden while improving accuracy.The conversation delves into the importance of having dedicated informaticists in each medical division to continuously improve EMR workflows. Dr. Patel envisions a future where all NICU progress notes follow a standardized format, enabling better communication and data analysis. She emphasizes that improving EMR systems is an ongoing process that requires cultural change within medical teams. The hosts and Dr. Patel explore the potential for standardized documentation practices across NICUs to enhance patient care and facilitate research, as well as the future possibilities for using AI in medical documentation. The episode concludes by highlighting the career opportunities in clinical informatics for young medical professionals and the potential for this work to significantly impact patient care, physician well-being, and medical research. Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textIn this episode of the Incubator podcast, Ben interviews Bryan King, an experienced respiratory therapist and educator in neonatal and pediatric care. Bryan shares his journey into respiratory therapy, which began unexpectedly after initially pursuing x-ray technology. He discusses his passion for working in the NICU and the challenges of treating increasingly smaller premature infants.The conversation delves into the evolution of neonatal respiratory therapy, focusing on the impact of surfactant and antenatal steroids in improving infant lung compliance. Bryan emphasizes the importance of avoiding lung hyperexpansion in nano-premies and discusses various ventilation strategies, including volume-targeted ventilation, high-frequency ventilation, and pressure support.Bryan shares insights on selecting appropriate ventilation modes and settings, stressing the need to adapt strategies based on individual patient responses. He advocates for having a diverse set of tools and modalities available in Level 4 NICUs to provide comprehensive care and education.The interview also touches on the challenges of weaning patients from ventilators and the importance of considering long-term outcomes rather than focusing solely on immediate blood gas results. Bryan discusses his experience as a non-physician educator teaching physicians and emphasizes the value of lifelong learning in the medical field.Throughout the conversation, Bryan shares valuable tips for respiratory care, including the importance of encouraging spontaneous breathing, understanding ventilator feedback, and being open to trying different approaches when standard methods aren't effective. He also mentions his current project of writing a book about his experiences as an educator in the field of neonatal ventilation.The episode provides a wealth of knowledge for healthcare professionals working in neonatal and pediatric respiratory care, emphasizing the importance of adaptability, continuous learning, and patient-centered approaches in this rapidly evolving field. Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textIn this episode of Beyond the Beeps, the conversation explores the experiences of fathers in the NICU and the challenges they face. It highlights the emotional journey of Alex Dominguez, whose daughter Mahalia was born prematurely at 25 weeks and spent six months in the NICU. The conversation touches on the struggles of infertility, the complications during pregnancy, and the difficult decision to deliver the baby early. It also discusses the impact of the COVID-19 pandemic on visitation rights in the NICU. Alex's unwavering dedication to his daughter and his ability to find peace in difficult circumstances are inspiring. Alex Dominguez shares his experience as a father in the NICU and the challenges he faced. He talks about the importance of being physically present and close to his daughter, even if he couldn't be by her side 24/7. Alex also discusses the perception of fathers in the NICU and how he sometimes felt overlooked or disrespected. He emphasizes the need for healthcare professionals to treat both parents equally and provide clear and personalized communication. Alex reflects on the importance of patience and perseverance during the NICU journey.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textIn our latest Journal Club episode, we review several important recent studies in neonatology. We begin by discussing a paper on the changing trends in Apgar scoring, noting a shift from scores of 10 to 9, likely due to increased recognition of normal transitional acrocyanosis.Next, we examine a study on using ChatGPT and Google Translate for pediatric discharge instructions, finding mixed results across different languages. We then review new transfusion guidelines for very preterm neonates, featuring an interview with co-author Dr. Ravi Patel who provides insights on the guideline development process and implementation considerations.We also discuss an observational study from Sweden on early skin-to-skin contact and its potential benefits for reducing intraventricular hemorrhage and sepsis in preterm infants, though we note limitations in the study design.Additionally, we review a pilot randomized trial comparing whole-body hypothermia to targeted normothermia for neonates with mild hypoxic-ischemic encephalopathy. The study found no clear benefits to cooling in mild cases and highlighted the need for further research.Finally, we highlight an op-ed emphasizing the importance of addressing mental health needs of new fathers, especially those with infants in the NICU. We note that while screening all NICU parents for postpartum depression is recommended, it is often overlooked, particularly for fathers.Throughout the episode, we provide thoughtful analysis of the studies' methodologies, findings, and clinical implications, offering valuable insights for our community. We hope this Journal Club helps keep our listeners up-to-date on the latest research and encourages critical thinking about how to apply these findings in clinical practice. Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textEarly skin-to-skin contact and the risk of intraventricular haemorrhage and sepsis in preterm infants. Johansson MW, Lilliesköld S, Jonas W, Thernström Blomqvist Y, Skiöld B, Linnér A.Acta Paediatr. 2024 May 27. doi: 10.1111/apa.17302. Online ahead of print.PMID: 38803030Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textNine is the New Ten of Apgar Scores: An Observational Retrospective Cohort Study. Everett SS, Bomback M, Roth P, Goldshtrom N, Polin RA, Lyford A, Hays T.J Pediatr. 2024 Jun 14:114150. doi: 10.1016/j.jpeds.2024.114150. Online ahead of print.PMID: 38880381Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textClinical Practice Guideline for Red Blood Cell Transfusion Thresholds in Very Preterm Neonates. Deschmann E, Dame C, Sola-Visner MC, Fustolo-Gunnink SF, Guyatt GH, Patel RM, Stanworth SJ; Neonatal Transfusion Network.JAMA Netw Open. 2024 Jun 3;7(6):e2417431. doi: 10.1001/jamanetworkopen.2024.17431.PMID: 38874929 Free article.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Dr. Jill Maron, a neonatologist and physician-scientist, discusses the importance of saliva in healthcare, focusing on non-invasive prenatal testing and feeding tolerance in premature infants. She shares insights on her research journey, leadership role in neonatology, and the value of mentorship and resilience in personal growth. The podcast highlights the potential of utilizing saliva for diagnostic purposes and emphasizes the significance of industry partnerships for innovative medical solutions.

Send us a textIn this special Father's Day episode, host Daphna Barbeau interviews Alex Zavala, known as the "NICU Dad". Alex shares his emotional journey of becoming a father to his daughter Emerson, born at just 27 weeks.Alex vividly recounts the day his wife's water broke, the frantic rush to the hospital, and the overwhelming fear and uncertainty as Emerson was delivered via emergency C-section weighing only 2 pounds 5 ounces. He describes feeling like he was thrust into a nightmare, trying to support his wife, make logistical plans, and grapple with the possibility of losing his daughter.During Emerson's 67-day NICU stay, Alex did the "NICU dad shuffle" - spending early mornings with his daughter, tag-teaming with his wife in the afternoons so she could be there while he went to work, and returning in the evenings. He highlights the unique struggles dads face, including feeling like an afterthought, battling stress, anxiety and PTSD symptoms, weight gain, and having their trauma go unrecognized.After Emerson came home, Alex continued to face challenges. His stress increased without the monitors and NICU staff, he became a stay-at-home dad, and suffered health issues from the emotional toll. Seeing a need, he started The NICU Dad website and podcast as resources for dads.Alex's advice for NICU dads: take care of yourself to be the best version of yourself at home, seek counseling, join peer support groups, and utilize resources from organizations like March of Dimes and Hand to Hold. For healthcare professionals, he advocates involving dads from the start, understanding their unique trauma response, and encouraging them to actively participate in their baby's care. Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

Send us a textIn this episode, Mbozu and Shelly-Ann are joined by Professor Pradeep Suryawanshi, a neonatologist, researcher and educator from Pune India. Professor Suryanwanshi discusses his journey as a neonatologist and his work in India and Australia, the process of developing a neonatal care unit and the importance of mentorship. He also discusses  factors contributing to India's progress in neonatal care, the challenges and progress in implementing surfactant therapy as well as advice on work-life balance.Resources mentioned in episode:Dr. Pradeep Suryawanshi website: https://www.drpradeepsuryawanshi.com/Neo POCUS course: https://www.drpradeepsuryawanshi.com/neopocus-course/Contact:   drpradeepsuryawanshi@gmail.comSupport the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!