S.T.A.B.L.E. - CARDIAC MODULE. RECOGNITION AND STABILIZATION OF NEONATES WITH SEVERE CHD. 2ND EDITION

• Acronyms Used in this Book
• Introduction
Part 1 History and Patient Assessment
• Incidence of Congenital Heart Disease (CHD)
• History and Patient Presentation
• Neonatal History
• Pregnancy, Labor, and Delivery History
• Maternal Medical History
• Recurrence Risk
• Patient Assessment
• Neurologic Status
• Physical Appearance – Size and Features
• Infant of the Diabetic Mother (IDM)
• Small for Gestational Age (SGA) Infants
• Syndromes and Chromosomal Abnormalities Associated with CHD
• Trisomy 21 (Down Syndrome)
• Trisomy 18 (Edwards Syndrome)
• Trisomy 13 (Patau Syndrome)
• What does it mean? Let’s talk about a persistent Patent Ductus Arteriosus (PDA)
• Monosomy X (Turner Syndrome – XO chromosome)
• CHARGE Syndrome
• VACTERL Association
• 22q11 2 Deletion Syndrome (22q11 2DS)
• What does it mean? Conotruncal
• Color
• Oxygen Saturation
• Vital Signs - Respiratory Rate and Effort
• Vital Signs – Heart Rate and Rhythm
• Treatment of SVT
• Adenosine
• Vital Signs – Blood Pressure (BP)
• Shock
• Bruit
• Pulses
• Skin Perfusion and Appearance
• Precordial Activity
• Heart Sounds
• Heart Murmur
• Liver Size and Location
• What does it mean? Situs solitus, situs inversus, and heterotaxy
• Diagnostic Tests
• Differential Diagnosis
Part 2 Clinical Presentation and Stabilization of Neonates with Severe CHD
• What does it mean? Let’s talk about CHD that is ductal dependent
• Pharmacology – Prostaglandin E1 (PGE, Alprostadil, Prostin)
• Left-Sided Obstructive Lesions, Ductal Dependent for Systemic Blood Flow
• Underlying Concepts
• Coarctation of the Aorta
• Interrupted Aortic Arch
• Aortic Valve Stenosis
• Hypoplastic Left Heart Syndrome
• Left-sided Obstructive Lesions – Clinical Presentation
• Left-Sided Obstructive Lesions – Chest X-Ray
• Left-sided Obstructive Lesions – Initial Stabilization
• Case Study: 1-Day old infant with HLHS
• Cyanotic Congenital Heart Disease, Not Ductal Dependent for Pulmonary Blood Flow
• Underlying Concepts and Stabilizing the Cyanotic Neonate with Suspected CHD
• Tetralogy of Fallot
• Tetralogy of Fallot – Clinical Presentation
• Tetralogy of Fallot – Chest X-Ray
• Tetralogy of Fallot – Initial Stabilization
• What does it mean? Let’s talk about hypercyanotic/tet spells
• Hypercyanotic/Tet Spell – Treatment Principles
• What does it mean? Let’s talk about Double Outlet Right Ventricle (DORV)
• Tricuspid Atresia
• Tricuspid Atresia – Clinical Presentation
• Tricuspid Atresia – Chest X-Ray
• Tricuspid Atresia – Initial Stabilization
• Truncus Arteriosus
• Truncus Arteriosus – Clinical Presentation
• Truncus Arteriosus – Chest X-Ray
• Truncus Arteriosus – Initial Stabilization
• Total Anomalous Pulmonary Venous Connection
• Supracardiac TAPVC
• Cardiac TAPVC
• Infracardiac TAPVC (also called infradiaphragmatic)
• Total Anomalous Pulmonary Venous Connection – Clinical Presentation
• Total Anomalous Pulmonary Venous Connection – Chest X-Ray
• Total Anomalous Pulmonary Venous Connection – Initial Stabilization
• Ebstein Anomaly
• Ebstein Anomaly – Clinical Presentation
• Ebstein Anomaly – Chest X-Ray
• Ebstein Anomaly – Initial Stabilization
• Cyanotic Congenital Heart Disease, Ductal Dependent for Pulmonary Blood Flow
• Underlying Concepts
• Stabilizing the Cyanotic Neonate with Ductal Dependent Pulmonary Blood Flow
• Pulmonary Atresia with Intact Ventricular Septum (PA-IVS)
• Pulmonary Atresia with Intact Ventricular Septum (PA-IVS) – Clinical Presentation
• Pulmonary Atresia with Intact Ventricular Septum (PA-IVS) – Chest X-Ray
• Pulmonary Atresia with Intact Ventricular Septum (PA-IVS) – Initial Stabilization
• What does it mean? Let’s talk about PA-IVS and Ventriculocoronary Connections
• Pulmonary Atresia and Ventricular Septal Defect (PA-VSD)
• Pulmonary Atresia and Ventricular Septal Defect (PA-VSD) – Clinical Presentation
• Pulmonary Atresia and Ventricular Septal Defect (PA-VSD) – Chest X-Ray
• Pulmonary Atresia and Ventricular Septal Defect (PA-VSD) – Initial Stabilization
• Transposition of the Great Arteries (TGA)
• Transposition of the Great Arteries – Clinical Presentation
• Transposition of the Great Arteries – Chest X-Ray
• Transposition of the Great Arteries – Initial Stabilization
• What does it mean? What is the difference between D-TGA and L-TGA?
Part 3 S.T.A.B.L.E. – Cardiac Module
• Introduction
• Sugar and Safe Care Module
• Glucose Production and Utilization Rate
• Initial IV Fluid Rate and Target Glucose Levels
• IV Access and Central Lines
• Umbilical Vein Catheter (UVC)
• Umbilical Artery Catheter (UAC) and Peripheral Arterial
• Umbilical Catheter Safety
• Peripherally Inserted Central Catheter (PICC)
• Temperature Module
• Airway Module
• O2 Saturation, Hemoglobin, and CHD
• O2 Content
• What does it mean? What is Regional Oximetry Monitoring – Near Infrared Reflective Spectroscopy (NIRS) Monitoring?
• Pulse Oximetry Screening (POS) for Critical Congenital Heart Disease (CCHD)
• Blood Pressure Module
• Methods for Measuring BP
• Oscillometric Measurement – How Does it Work?
• Lab Work Module
• Blood Sugar
• Blood Gas
• Lactic Acid/Lactate
• Electrolytes and Renal Function Tests
• Ionized Calcium
• Magnesium
• Liver Function Tests
• Complete Blood Count with Differential
• Cardiac Enzymes: B-Type Natriuretic Peptide (BNP) and Troponin I
• What does it mean? Let’s talk about Genetic Testing
• Emotional Support Module
• Appendix 1 – Palliative and Surgical Repair of the Lesions Discussed in this Book
• Appendix 2 – Medications Used in the Treatment of Neonates with CHD
• References
• Index

S.T.A.B.L.E. - Cardiac Module: Recognition and Stabilization of Neonates with Severe CHD will be valuable to any healthcare provider responsible for the recognition and stabilization of newborns with severe forms of CHD. Nurses, advanced practice nurses, physician assistants, and physicians working in all settings— neonatal, neonatal transport, well-baby, and pediatric and cardiac intensive care settings will gain critical knowledge for the highest standard of care.

The updated 2nd edition contains more than 120 new full-color illustrations making it an excellent teaching tool for healthcare providers and parents!

The 2nd edition features:
• A comprehensive explanation of neonatal CHD, starting with a history and physical examination.
• New! Common palliative care for and surgical correction of the CHD lesions illustrated in this book.
• Expanded tables and figures help explain complex concepts in a practical, easy-to-understand format.
• Thorough explanation of critical forms of CHD, covering anatomy, blood flow pattern, clinical presentation, and initial stabilization.

The illustrations in the book are very useful for explaining complex heart lesions and palliative and surgical repair to parents of infants with severe forms of CHD.

Author
Dr Karlsen is a neonatal nurse practitioner who has been involved in neonatal care in a variety of settings including transport, education, patient care, and simulation for more than 35 years. She is the founder of the internationally recognized S.T.A.B.L.E. Program and author and developer of The S.T.A.B.L.E. Program Pretransport / Postresuscitation stabilization neonatal education course, The S.T.A.B.L.E. – Cardiac Module course (book and slide program), the STABLEize™ app (for Apple and Android), The S.T.A.B.L.E. Program’s Gestational Age and Physical Assessment of the Newborn slide program, and the Neonatal Stabilization Scenarios Guidebook, based on The S.T.A.B.L.E. Program curriculum. More than 650,000 students have completed a S.T.A.B.L.E. Program course, and the Program is taught in more than 45 countries.
Dr Karlsen serves as the Program Director for S.T.A.B.L.E., and she travels domestically and internationally to teach The S.T.A.B.L.E. Program curriculums and Instructor Courses. Since 1985, her clinical affiliation is the Level 4 neonatal intensive care unit at Intermountain Healthcare Primary Children’s Hospital in Salt Lake City, Utah, where she serves as a neonatal nurse practitioner on the cardiac patient team.
Dr Karlsen is the recipient of numerous awards and recognition: the AWHONN/Johnson & Johnson 2003 Childbirth Nursing Award, the March of Dimes 2004 Leadership in Healthcare Nurse Award, the University of Utah College of Nursing 2005 Outstanding Doctoral Student Award, the 2010 National Association of Neonatal Nurse Practitioners NNP Excellence Award, and the 2014 National Perinatal Association, The Individual Contribution to Maternal & Child Health at the National and International Level Award. In 2019, she was awarded a Fellowship in the American Academy of Nursing to recognize her worldwide impact on improving neonatal outcomes through the S.T.A.B.L.E. Program’s interprofessional neonatal education.
Collin G. Cowley, MD, joined the faculty of the University of Utah in 2000 after completing fellowships in pediatric cardiology and interventional catheterization at the University of Michigan. Over the next 20 years, he pursued his interests in clinical care, research, education, and clinical administration and was promoted to tenured Professor in 2013. Dr Cowley is a fellow of the American Academy of Pediatrics and the American College of Cardiology. Dr Cowley remains passionate about patient care and recently retired from the University of Utah to join Mednax Health Solutions in opening several pediatric cardiology offices in northern Utah.