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Hmmm biasalah namanya wad intensive care unit (NICU) plus special care baby unit (SCBU)....manang tangan, lapas satu, satu then ada lagi kraja yang teroverlap. Mesti buat yang "priority" dulu~ buat dulu yang urgent/stat. Palagi jadi nurse yang incharge stock n equipment ani awal awal pagi before 8am sudah mengorder routine wad list~ cek dulu dalam compartment setiap ubat ubat dalam trolley cukup kah inda tau jauh berkurangan. Hmmm let me recall my memory ingat ingat lupa jua tapi ubat intravenous yang selalu kana gunakan ie Calcium gluconate, potassium chloride, magnesium sulphate, dopamine, dobutamine masuk through intravenous (IV) line~ either peripheral line, long line atau umbilical venous line (UVL/UVC). Heparin goes to arterial line ataupun umbilical arterial line (UAL/UAC). kadang baby yang very ill need TPN (Total Perenteral Nutrition) usually goes through long line which is contain Lipid n Nutriflex. Common medication such antibiotics given like Netilmicin n BenzylPenicillin (crystapen). Others Aminophylline, Augmentin, Fortum, Zinacef, Flagyl, Metronidazole, Indomethiacine, Netilmicin, Phosphate sandoz, Ranitidine, Rocephine, Imipienam(Tienam), Unasyn, Atu baru treatment room, bilik untuk menyimpan ventilator n CPAP (Continous Peep Airway Pressure), ABG/CBG (arterial n capillary blood gases) machine lagi mesti di calibrate. Serum bilirubin machine lagi to analyse blood which is taken from jaundice baby yang need phototherapy. Segala pencuci n for dusting apa like hibitane n hibidil, chlorhexidine, cidex, methylated alcohol, povidone mesti jua dicek karang apa kan pencuci untuk our equipment such as ventilator/CPAP bagas bepakai, syringe pump/syringe driver, oxygen jar, ambubag, suction catheter, segala tubings, headbox, head shield, cot, incubator, resuscitaire etc. Lain lagi order sabun, lotion/cream tuk baby such as baby bath, dropolene, KY jelly, white paraffin ointment tuk moisturise baby skin yang kulitnya kering, zinc oxide cream tuk nappy rashes. Masa ani alhamdulillah, amah sudah dapat send sterilising equipment to CSSD macam inducer/airway, masks apa. Instrument yang bagas pakai like umbilical catheter set, sterile scissor, ventilator parts apa, all instruments send to MICU (Medical ICU). Daily order macam cotton, gauze, top n tail, orange stick, spatula, crepe paper, dressing pack, suture pack, suture removal set, hand towel etc pun mau jua. Eye pad mesti jua kan diantar ke Linen kan dijahit dijadikan kacamata hitam untuk menutup mata for jaundice baby kasian baby silau karang matanya masa baby on phototherapy treatment (lampu biru). Paling penting have to check every shift "Emergency Trolley" riuh karang...Masa ani emergency trolley mesti di audit supaya sentiasa always get ready beguna dimasa saat saat kecemasan. Lawa udah emergency trolley~colourful ceria jua our environment. Ada 5 drawer. Ist drawer tersimpan ubat ubat yang digunakan bila didalam keadaan critical macam Adrenaline, Metroclopromide, Heparin, Adenosine, Konakion (Vitamin K), Indomethiacine, Losec etc...Prostin disimpan dalam fridge. 2nd drawer,disimpan ETT (Endo Tracheal Tube) ada size 2, 2.5,3, 3.5, 4 according to age. Offcourse untuk premature (preterm babies) pakai size 2 or 2.5. 3th drawer tempat menyimpan laryngoscope with straight or curved blade size 0, 00 n 1, cek ada battery kah masih, plaster doudenum n white plaster to secure ETT position. Dalam drawer ani jua ada mask digunakan masa ambubagging, ada inducer/airway jua. 4th drawer, Bone marrow n Lumbar puncture (LP needle), umbilical catheter size 4 for umbilical arterial line (UAL) n size 6 for umbilical venous line or catheter (UVL). Ambubag with reservoir 600ml for preterm n 2600 for term/big baby. 5th drawer, ada disposable/sterilising gloves. hand rub, torch n scissor. Tempat nyimpan bottles 500mls line macam normal saline, heparinised saline, 50% Dextrose, water for injection etc. Ada satu trolley lagi sama jua macam emergency trolley tapi ani khas untuk drainage preparation, long line etc. Dalam fridge ada Survanta for baby yang pakai ventilator, Hapatitis vaccine, Hepatitis immunoglobulin, for eyedrops like Gentamycin eyedrop, Chloramphenicol eyedrop....eyefrop kan di apply ke mata baby prior to ROP screening macam mydriacyl n mimims. Dibilik linen, tempat menyimpan jaundice gown baby, baby blanket, Dr's sterilising gown n disposable gown apa. Pampers pakai buang, parents yang mengadakan. Tapi alhamdulillah, ada jua parents yang masani atau yang dulu anaknya di scbu mengunjuk pampers untuk baby yang ada pada masa ani...terima kasih. Pas tu masuk lagi kebilik store perkakas. Mun habis order ke medical store macam needles surflo, terumo, blades. plaster, 3 way tube, T-connector, medi swab, op-site, syringes, sterile gloves, mask, apron, suction catheter, umbilical catheter, tube feeding, ETT, ventilator set n tubings, humidifier, syring pumps n stand, trans swabs, bottle specimens, extension wire beguna banar kalau baby pakai 3 photo light banyak plug kan dipakai alum lagi masuk plug syringe pump apa. Asal keluar masuk barang saja, mesti tah dicatit dalam bin kad. Disini jua disimpan oxygen flow meter n apnoea monitor to detect any possible lung n heart problem especially in preterm babies due to immature developmental organ. Selalunya, we give them multivitamin, ferrum (iron) n folic acid even during discharge. That is why our preterm babies in paediatric still kana prescribe such medicines. As usual before discharge, baby back to mum in post natal wards or asal saja baby mencapai berat badan 1.8 kg, we give BCG immunisation (pelali), its not vaccination like flu or H1N1 vaccine. BCG selalunya ada scar because it is given sub-cutaneously (under the skin) besungkit way of injection. Atau dalam bahasa kami sampai "nampak bulan"...esok hariraya hehe. Injection given must be on the right arm side. Kalau baby begoyang tangannya, possibility site of injection kan lari, jadinya injection site temasuk kedalam, nda nampak bulan or vaccinenya tambus keluar. So that, good way in handling baby position n the correct way of injection technique is very important. Hampir 2 tahun meninggalkan scbu, wawa a bit confuse pasal dilution nya, walaupun sudah bekursus BCG tahun 2001. Bila kitani not sure, ada baiknya kitani belajar balik dari orang yang mahir dalam membagi immunisation ani. Baik jua ada geng midwife di post natal ward kan minta demo n lapas atu baru kitani membari sendiri. Palagi baibun tah tarus manainda jumpa geng. Baik jua wawa biasa banar dengan diorang ani since wawa stay dihostel masa time students. Dangan wawa bising makan sahur n liat TV sama sama. Diorang pun kadang minta tolong jua minta resite IV either untuk drip atau ubat antibiotics. Atutah sebenarnya keraja "teamwork" disini memainkan peranan. Kerjaya ani memerlukan kitani bekeraja bukan sorang tapi beramai. Apanya...muafakat membawa berkat hahaha....I like tho!

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