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haematology

Q: Portacath or Hickman Line, madam?

7 Dec, 08 | by Bob Phillips

PortacathA 6 year old girl with Acute Lymphoblastic Leukaemia presents with another episode of febrile neutropenia with positive blood culture from her Hickman line. On a ward round, her parents discuss that they would like her to have a Portacath device inserted so that she can go swimming and is more comfortable around her friends. They are worried that she will be more susceptible to infection as the device is just below the skin and would like to avoid further hospital admissions. They ask if the portacath will increase her risk of infection during her remainder of her treatment? more…

Q: How long do you wait to clamp a cord?

7 Dec, 08 | by Bob Phillips

Too many red cellsWhen I was doing neonates, it was considered good practice to get little babies spliced away from their Mother, given oxygen to breathe and wrapped up warm, all pretty damn quickly. I keep hearing rumours from my neonatally biased friends that perhaps there are other, better ways of doing things.

So – how long do you advise waiting until clamping the umbilical cord after delivery? Two, three minutes (where the baby can chill & develop polycythaemia?) or as little time as it takes you to get hold of a clamp (so the child can be deprived of the last few teaspoons of good fetal blood?).

more…

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