Welcome to the Abstractor’s Corner! This section is devoted to questions, answers and comments from abstractors in recent months. Our goal is to build a unified abstractors team across Canada by maintaining open lines of communication and support. Please note that issues presented here pertain to the NEW CNN Application rolled out in 2010. You may want to print off these questions and retain them for future reference, as the content may sporadically change.
IMPORTANT: Previously there was a discrepancy in whether delivery room deaths that were to be included were > 22 wks or > 22 wks. It should be > 22 wks, the next manual rollout will have the change!
QUESTION 1: Baby is born in hospital A on 8 Sep 2009 and goes home on 9 Sep 2009. Suddenly baby gets sick and goes to hospital B on the 10 Sep 2009. The case gets worse and baby needs to be admitted in NICU at hospital B. The NICU admission in this case is outborn. The birth hospital would be hospital A. What will the "Transferred From" place be?
a) Children Emergency - Hospital B
b) Hospital B
c) Home
d) Hospital A
ANSWER 1: c
QUESTION 2: On the daily chart, what do we record for ventilation? If the baby was on IPPV and CPAP for the specified day we would only record IPPV and not CPAP?. As for oxygen we would only record if >21% irrespective of mode of ventilation?
ANSWER 2:Yes, record the HIGHEST level of ventilation
QUESTION 3: Mother screen: If it is a C-section and there has not been a natural/artificial ROM prior to C-section how should I enter that? Do I leave it blank?
ANSWER 3::Rupture of membrane was done at C section - then enter that as time.
QUESTION 4: Antenatal screen: For Para, could you tell me what the viability cut off is in weeks? Is it more than 20 weeks?
ANSWER 4::yes
QUESTION 5: SNAP: If there is no lactate taken in this period, do I leave this blank? Do we leave all unknown values as blank?
ANSWER 5::leave blank, the validation will still go through
QUESTION 6: On the Patient Chart screen, it asks for days when narcotic infusion is given. I had a single instance when Fentanyl was given, in conjunction with the cocktail for intubation. It was a one-time dose, not technically a transfusion. Does it still count?
ANSWER 6: We are interested in Narcotic infusion only and not boluses.
Boluses given on Day 1 and Day 3 are captured on NTISS screen.
QUESTION 7: Many of our babies have “increased periventricular echos” on their HUS’s.How do you want me to score that?
ANSWER 7: Early US showing PV echo would be under "Intraparenchymal lesions".
Remember to check whether it resolved or not - if not resolved it has implications.
Those which resolve are of possibly no consequence.
QUESTION 8: If there is no head circumference done on admission, what do I enter in the field? The manual states to leave field blank. If I leave the field blank, the validation fails because it is a required entry.
ANSWER 8::leave blank for now, future versions of CNN will make the field not mandatory.
QUESTION 9: Where do I enter CPAP and PEEP information on the resuscitation screen, and free-flow oxygen information?
ANSWER 9::CPAP and PEEP info is entered as "PPV via bag and mask" and for free-flow and blow-by oxygen simply select Stimulation and enter the concentration.
QUESTION 10: What should I do if admission weight was not recorded because of critical condition and instability?
Answer 10: Enter an estimated admission weight
to validate the admission screen.
QUESTION 11: For EEG results, do you want the “worst” results? The patient I am doing had two done, the initial one being abnormal and the one after cooling almost normal. Which should I score?
Answer 11: Enter the worst one
QUESTION 12: Is albumin not being scored anymore? Under what are we scoring a PFO (Defect of foramen ovale)?
Answer 12: We are not collecting albumin any more. PFO is other congenital malformation.
QUESTION 13: A new mode of ventilation is being used that doesn't appear in CNN - MMW. MMV is a cross-over between CPAP and IPPV, so if we're scoring highest mode of ventilation, do we score as NI or IPPV?
Answer 13: IPPV please.
QUESTION 14: On the DIangosis screen, is total bilirubin conjugated and unconjugated bilirubin?
Answer 14: Yes
QUESTION 15: Recently, an abstractor came across a reported case of gangrene in the patients chart and asked if we collected this.
Answer 15: No