Dr. Allen Cherer is a neonatal care expert with over 30 years of medical accomplishments to his name.

Tag: healthcare


Coronavirus and Pregnancy: What to Know

Historically, viral illnesses become more serious in the very young, the elderly and in individuals having a weakened immune system. Given that victims of all ages have become infected with the coronavirus, many are understandably concerned about the effect the illness may have on expectant mothers.

Pregnancy and Covid-19

The World Health Organization reports that in a study of 147 pregnant women, eight percent developed more severe forms of the illness. One percent required critical care.

A study of nine afflicted women who gave birth indicated that none of the infants tested positive for the virus. But, the women all became infected during the last trimester of pregnancy. It remains yet unknown how the virus might affect a fetus during the early months of development.

Another study involved 10 newborn infants who developed serious forms of the illness. According to a physician from the Northwestern University Feinberg School of Medicine, the amniotic fluid, breast milk, and cord blood were tested. But, all of the fluid was negative for Covid-19. So, physicians do not believe that the illness passes from the mother to the developing infant. Theories revolving how the babies became infected include that the women may not have undergone testing and found to be afflicted before delivery. The babies may have come in contact with their infected mothers shortly after birth.

An obstetrician affiliated with the American College of Obstetricians and Gynecologists advises that pregnant women should undergo testing at their initial appointment and separated from patients who tested negative. Pregnant women are advised to use the same precautions recommended for the general public.

About Covid-19

After exposure, individuals may develop symptoms in two days to two weeks. The majority of afflicted individuals suffer symptoms that are equated with the common flu. The experience may include fever, generalized fatigue and upper respiratory symptoms. Others suffer muscle aches and diarrhea. The World Health Organization reports that the virus causes serious illness in one out of every six patients. More severe cases exhibit difficulty breathing and shortness of breath. Individuals experiencing more serious symptoms are advised to seek medical attention.

Scientists recently revealed that the virus has two strains, one of which is more aggressive than the other. Health care providers also report that it is possible for individuals to suffer a relapse, which is often more serious.

Transmission occurs through airborne droplets or coming in contact with infected animals, surfaces or fecal matter. 


hospital photo

Reducing Costs and Saving Lives

Sick newborns often rely on a ventilator to supply oxygen, and are tethered by a plastic endotracheal tube (ETT).  Often-times, this tube accidentally pops out.  This represents the fourth most common complication experienced by newborns in NICUs.  It can cause oxygen deficiency (hypoxia), high carbon dioxide levels in the blood, trauma to their airway, intraventricular hemorrhage, code events, and more.  “Unplanned extubations” also have the potential to nearly double the time of a hospital stay and increase the cost of care by $36,000 per patient.  Because of this, the Children’s National Health System’s NICU spearheaded a quality-improvement initiative to reduce the prevalence of unplanned extubations.

Many providers order a chest X-ray daily to verify the positioning of the ETT and prevent unplanned extubations.  However, this costs a lot of money, and potentially exposes infants to radiation.  Nobody needs to spend more money to expose themselves to more radiation, and that is particularly true for premature infants.  As part of their initiative, Children’s National has found that these same X-rays can be performed just twice weekly.  This sounds like a pretty simple initiative, but its consequences are surprisingly far-reaching: it lessens the chances of the breathing tube accidentally popping out, reducing radiation exposure, and saving roughly $1.6 million a year.  

The project started in July 2015, when Children’s National’s monthly X-ray expenditure was a whopping $289,520.  By the end of the year, that number had fallen down to $159,424, resulting in over $1 million in annual savings.  Within a month of implementation, unintended extubations dropped from 1.18 events per 100 ventilator days to .59.  Within five months, that number fell down .41.  Because of this initiative, unintended extubation rates at Children’s National are significantly lower than reported on various quality indices.  However, they don’t want to stop now, pledging to bring the rate down .3 events per 100 ventilator days.  I’m eager to see them reach their goal!

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