poal medical abbreviation nicu

The volume of inhaled gas must exceed the volume of dead space. The electrode will be applied by the nurse to the anterior chest wall or other acceptable site. Furthermore, CPAP increases stabilization of the chest wall musculature and decreases activity of the intercostal inspiratory inhibitory reflex. It goes through the mouth into the stomach. DOPE (what to think with breathing issues) = Displacement, Obstruction, Pneumothorax, Equipment . Recommendations for the initial respiratory settings for other neonatal conditions will be found on the following table. In: Avery GB, (ed). ), Nippling Sucking on a bottle filled with formula or breastmilk. Thirty mL equals about 1 fluid ounce. At UIHC, caffeine is preferred for the routine management of apnea of prematurity. Maximum amplitude (delta P/pressure wave) or tidal volume delivered is highly variable and is highly attenuated by the ETT and the tracheobronchial tree before reaching the alveolus. ), APGAR A means of evaluating, on a scale of 1-10, how a newborn baby adjusts to the environment outside the uterus immediately after delivery, Apnea A pause in breathing that lasts for more than 20 seconds, or is accompanied by a slow heart rate (bradycardia) or a change in skin color (Apnea is common among preemies who still have immature control of their breathing. Shock is corrected by use of normal saline or Plasmanate R; the dose is 10 cc/kg infused over 15 to 30 minutes. Intravenous fluids (D10W or D5W) are given at an initial rate of 60-80 ml/kg body weight per 24 hours with fluid therapy reassessed every 8-12 hours. Postnatal exposure to sedatives, hypnotics or narcotics. Common Terms and Abbreviations Used in the NICU Your baby is in a special part of the hospital. Medical POA abbreviation meaning defined here. It is theoretically capable of ventilating patients up to 35 kg. Aspiration: Breathing or inhaling fluid such as amniotic fluid, meconium or formula into the lungs. Thread entire suction catheter through ETT until thumb control is located at the end of the ETT adapter. Increasing O2 requirement or episodes of desaturation and apnea - "plugged tube." The treatment of the Respiratory Distress Syndrome (RDS) is directed at correction of the pathophysiological conditions that exist in this disease process: A) surfactant deficiency, B) hypoxia, C) acidosis, D) pulmonary vasoconstriction, E) atelectasis, and F) shock. d) Warning - It is extremely important to normalize PaCO2 rapidly by weaning Power/amplitude/delta P in order to avoid volutrauma from excessive tidal volumes. Thirty mL equals about 1 fluid ounce. Intermittent Mandatory Ventilation (IMV) - If significant apnea persists despite using both pharmaco-therapy and CPAP, the infant should be intubated and ventilated. ), Lumbar puncture (spinal tap) A test that uses a short, narrow needle inserted between two lumbar vertebrae into the area where there is spinal fluid (The spinal fluid is withdrawn for analysis. of 33%. This is nutrition fed straight into the bloodstream. IMV is most often used along with the babys own breathing rate in order to get enough oxygen into the childs body. Principles of neonatal assisted ventilation. Advance lubricated ETT nasally while maintaining placement of suction catheter. ), TPR Medical abbreviation for temperature, pulse, respiration, Tracheostomy (Trach) A surgical opening in the trachea, below the larynx (voice box), made to allow air to enter the lungs when the throat becomes obstructed, Transfusion A treatment for anemia in which red blood cells are added directly to the babys total circulating blood supply through an IV or a catheter, TTN (Transient Tachypnea of the Newborn) A condition resulting in an excess of lung fluid at the time of delivery, causing an elevated respiratory rate until the fluid is absorbed, Twin-to-twin transfusion syndrome (TTTS) A condition of the placenta that can occur in identical twin pregnancies (TTTS results in blood that passes from one twin baby to the other through connecting blood vessels within the shared placenta. ), IUGR See intrauterine growth retardation, IVH (intraventricular hemorrhage) Bleeding in an inner part of the brain near the ventricles (This is where premature babies have very fragile blood vessels that can easily rupture. Since amplitude or delta P is a measured value, we have decided that the Power setting is a more reliable and consistent way of adjusting this ventilator and thus we order changes in power in order to regulate ventilation by changing the distance the piston travels but either approach is completely valid. Initial settings need to be clinically adjusted to prevent episodes of desaturation or cyanosis. Increased risk of air trapping with severe reactive airway disease. Continuous Positive Airway Pressure (CPAP) - CPAP is effective in treating both obstructive and mixed apnea, but not central apnea. VI. 100% oxygen and transient hyperventilation with goal of an arterial pH value greater than 7.55 (1), and PaCO2 of 30-35 mm Hg, and a PaO2 of 55 mm Hg or greater. Use a stepwise process to set MAP: Thus, adjust MAP by decreasing conventional rate (by 5 bpm) while increasing PEEP (by 1 cm H. Also decrease PIP of Sigh breaths at the same time and by the same amount that you decrease the PEEP (e.g., PIP 16 and PEEP 10 to PIP 15 and PEEP 9). Adjust the amplitude until you achieve vigorous chest wall vibrations, usually occurs at an amplitude of 20-30. Your baby is getting special care. Carlo WA, Martin RJ. Keep the infant warm and dry to prevent hypothermia and shunting. ), Diuretic A medication that increases the amount of water that passes out of the body through the urine, Down syndrome A chromosomal abnormality, sometimes referred to as mongolism, characterized by physical malformations and varying degrees of mental retardation; often caused by an extra number 21 chromosome, Dx The medical abbreviation for diagnosis, Echocardiogram An ultrasonographic method of recording a picture of the heart as it is produced by the echo of sound waves (This can be used to evaluate both the structure and function of the heart. ET or ETT (endotracheal tube). F. If improvement is documented (an increase in PaO2 of 20 mm Hg, or a decrease in ventilator settings) within two hours, maintain the same dose. This is a tube put into a vein. An artificially created passage between two areas of the body, as in a ventriculoperitoneal shunt for hydrocephalus (This is a tube that drains fluid from the ventricles of the brain into the abdominal cavity.) ), Hyperbilirubinemia Excess bilirubin in the blood; a condition common in newborns, Hypercalcemia An excess amount of calcium in the blood, Hypercapnia (hypercarbia) An excess of carbon dioxide in the bloodstream, Hyperglycemia Abnormally high sugar levels in the blood, Hyperkalemia Excess amounts of potassium in the blood, Hypernatremia Excessive amounts of sodium in the blood, Hyperthermia Abnormally high body temperature, Hyperventilation Abnormally rapid breathing, Hypocalcemia Abnormally low levels of calcium in the blood, Hypoglycemia A condition that occurs when not enough glucose (sugar) is in the babys blood to use as a fuel for energy, Hypokalemia Too little potassium in the blood, Hyponatremia Too little sodium in the blood, Hypotension Abnormally low blood pressure, Hypothermia Abnormally low body temperature; a frequent problem with low-birth weight premature babies, Hypovolemia An abnormally low volume of blood in the body, I and O Abbreviation for input and output (It refers to the amount of fluids given by oral feedings or by IV, and the amount of fluid excreted in the urine or stools, as well as blood removed for testing, over a given period of time. Watkins PL, Dagle JM, Bell EF, Colaizy TT. What is POAB meaning in Medical? Pulmonary hypertension in pediatric patients. Practice permissive hypercarbia and accept higher PaCO2's to minimize the delivered TV. The optimal range for most premature infants will be 50 to 70 mm Hg. Excessive secretions in the nasopharynx and hypopharynx may also cause obstructive apnea. E. Cardiology consult, if indicated for echocardiography to rule out cyanotic congenital heart disease. CPAP is placing them on the an actual CPAP ventilator or placing the flow inflating mask over their mouth as the infant breaths on their own. to 30%. This means no food or liquid given by mouth. POAL is listed in the World's largest and most authoritative dictionary database of abbreviations and acronyms. ), Phototherapy A treatment for jaundice (Blue or green fluorescent lights are placed over the babys bed to help break down bilirubin into a form that can be removed in the kidneys. Thus check ABG's frequently (Q15-20 min) and decrease POWER/amplitude/delta P accordingly until PaCO2 35. : The inspiration time for the High Frequency breath is fixed at. Emergency Care Quarterly 1990;6(3):65-80, Figure 1. High-frequency ventilation in the treatment of infants weighing less than 1500 grams with pulmonary interstitial emphysema: A pilot study. J Pediatr 1990;116:942-949. Enteral feeding may mean nutrition taken . It is used to give fluids, medicines and nutrients to the baby. Respiratory distress syndrome (RDS) A condition that affects the lungs of preterm infants, caused by lack of surfactant; also called hyaline membrane disease, Retina The lining of the back of the eye that receives visual images, Retinopathy of prematurity (ROP) A disease affecting the retina of a preterm babys eye (ROP can lead to serious eye complications and even blindness. This may be normal or abnormal.). We comply with applicable Federal civil rights laws and Minnesota laws. Pediatrics Clin North Am, 1987;34:15-38. The distressed fetus will make reflex gasping movements and aspirate meconium stained fluid into the tracheo-bronchial tree. ), UAC/UVC (Umbilical Artery Catheter/Umbilical Vein Catheter) A soft plastic tube inserted into an artery or vein in the babys navel (It is used to give IV fluids or medications, to monitor blood pressure, and to obtain blood for tests. The use of this higher rate will decrease the depth and duration of these desaturation spells. Add KCl (2-3 meq/kg/d) to IV fluids after urine output is well established and K+ <5 mEq/L (usually 48-72 hours). The difference between the PIP ordered and the PEEP is the delta P, which represents the volume of gas generated by each high frequency pulse during the opening of the pinch valve (maximum generated volume occurs with a PIP of 50 cm with a minimum PEEP and an IT of 34 milliseconds). Martin RJ, Miller MJ, Carlo WA. One piece inverted on lip and around tube. Pediatr, 87:565-567;1991. Parenteral Nutrition (PN) allows us to meet a neonates requirement for growth and development when their size or condition precludes enteral feeding. NG tube (nasogastric tube). 1. Excessive nasal irritation - move NP tube to the opposite side, change position of infant. Peer Review Status: Internally Peer Reviewed. *. Adjust Power/Amplitude/delta P to keep PaCO2 45-55. NO or endothelium-derived relaxing factor is produced within endothelial cell from L-arginine by nitric oxide synthase (see Figure). Sometimes the heart rate drops along with it. A chest radiograph should be checked both 1 hour and 4 - 6 hours after the initial dose to avoid hyperinflation. Bacteria can leak into the abdomen (belly) or bloodstream through the hole. Factors to be considered include the frequency and duration of the episodes along with the level of hypoxia and the degree of stimulation needed. The University of Iowa. Any acutely ill child in the NICU in an increased ambient oxygen concentration must have at least daily arterial or fingerstick blood gas sampling. The Importance of Having a Relationship With Your Child's Pediatrician, Questions to Ask When Choosing a Pediatrician, Attention Deficit Hyperactivity Disorder (ADHD), Ear, Nose & Throat (Otolaryngology) Services, Gastroenterology, Hepatology & Nutrition, Hematology, Oncology & Blood and Marrow Transplant, Preparing for a Primary Care or Clinic Visit, Your Guide to Single Ventricle Heart Defects, Health Numeracy: Understanding Numbers in Health, Grocery Store Video Guides to Healthy Eating, Newborn intensive care unit (NICU NBISU, NBIC, ICN), Partners For Kids: Pediatric Accountable Care, The location is currently closed. A . Small for gestational age (SGA) A newborn is considered small-for-gestational age if her birth weight is below the 10th percentile on the standard growth curve for his or her age. Kinsella JP, Neish SR, Ivy DD, et al. Please see our Nondiscrimination Fineman JR, Wong J, Soifer SJ. Increase fluid administration gradually over the first week of life to 120-130 cc . (1) Inspiratory Time--All neonates should have aninspiratory time of 0.3 to 0.5 seconds and an expiratory time not less than 0.5 seconds unless the rate exceeds 60/minute. NICU (neonatal intensive care unit). Jaundice - causes falsely decreased values. Stark AR, Frantz ID. Prevent by routine suctioning,and adequate humidification. Dosages - The following is a guide to the initiation of medical therapy. If the infant is anuric or oliguric, caution must be used when administering this drug. Geggel RL. Persons with hearing or speech disabilities may contact us via their preferred Telecommunication Relay Direct high intensity light - i.e. ), Grunting A noise made by the baby indicating respiratory distress, Head ultrasound A painless test that uses sound waves to show the structures in the brain; used to detect bleeding into the brain or other suspected problems, Heel stick A method of obtaining blood samples by pricking the babys heel, Hematocrit (Crit) A test done to measure the concentration of red blood cells in the blood to check for anemia, Hemoglobin (hgb, hb) A substance in red blood cells that contains iron and carries oxygen, Hernia A weakness in the abdominal wall that causes a portion of the intestines to protrude into the umbilical or inguinal area (This may also occur with a problem of the diaphragm that causes the bowel to enter the chest cavity, resulting in underdevelopment of the lung. RDS (respiratory distress syndrome) Also called hyaline membrane disease, it is the result of a preemie having immature lungs. An alarm should sound if respiration ceases for more than 20 seconds, or if the heart rate drops below 100 bpm. Subsequent reinsertions may be accomplished the same way or by following procedure for insertion of nasogastric tubes. Infrasonics Infant Star Ventilator -- A flow interrupter which functions like an oscillator with a negative pressure phase generated by a Venturi effect. initially at 30% to minimize air trapping by also using a longer initial I:E ratio (30%:70% or 1:2.3). Sodium received as sodium bicarbonate will also have to be taken into consideration when calculating the daily sodium requirement. ), Jaundice A yellowish color of the skin and whites of the eyes (It is caused by a buildup of bilirubin in the body. The technical details of administration are discussed in the package insert and in the NICU Nursing Protocols on administration. Arterial blood gases pre- and postductal. a) Neonates - Initial MAP should be 2-4 cm above the MAP on CMV. Changes in FiO2 may be monitored by pulse oximetry or transcutaneous oxygen monitor. Naso-gastric tube (NG tube) A small plastic tube inserted through the nose or mouth and into the stomach (This tube is used for feedings when an infant is unable to breastfeed or drink from a bottle. Once oxygenation is adequate (FIO2 less than 0.70) slowly lower the MAP by decreasing the PEEP by 1 cm H2O per change (Q4-8h). One hundred grams is about 3.5 ounces. This is a metric unit of volume. Follow methemoglobin (met-Hgb) levels at 1, 2, and 4 hours then Q6h - 8h while on 40 ppm until met-Hgb level is stable. Reduce the amplitude of the oscillations by 3 units per change (Q1-2h) until the PCO2 rises. This is a gas in the air we breathe. A. Minimize by proper positioning of infant and alternating nares every 5 to 7 days. Nondiscrimination Other critically ill or medically unstable newborns may also receive care in the NICU. Arrow. Wean power/amplitude/delta P to keep PaCO2 45-60 mmHg. Risk factors for Chronic lung disease in infants with birth weights of 751 to 1000 grams. AEDF = absent end diastolic flow . ), Oxygen hood (Oxyhood) A small plastic hood placed over the babys head, giving the infant a measured amount of oxygen and warm mist, Parenteral nutrition (PN) Nutrition that is given by IV, rather than through the stomach and the intestines, Patent ductus arteriosus (PDA) A blood vessel in the fetus that allows oxygen-rich blood from the placenta to bypass the left side of the heart and lungs (Before birth, blood flows through this blood vessel to the rest of the body. PaCO2 < 35 mm Hg correlates with an increased risk of pneumothorax. IMPORTANT: If oxygenation is lost during weaning when Peepwas decreased, manually "bag" the infant back up to restore lung volumes and reset Peep at 2-3 cm above the previous value. UVC (umbilical venous catheter). May become occluded or plugged with secretions despite suctioning. Meaning. To decrease the delta P needed and thus minimize the delivered TV in micro-preemies when air trapping is not a concern. Decrease CPAP pressure gradually to 4-6 cm and maintain the pressure at this level until tachypnea and retractions have resolved. In either case, close surveillance of chest wall movement and frequent monitoring of blood gases, especially during the first 3 hours after dosing, will minimize the complications of either volutrauma or atelectasis. Obstructive apnea A pause in breathing that occurs because a babys airway is blocked and little air can get through (It can happen even when a baby is moving his chest to breathe. 2 meanings of POAB abbreviation related to Medical: Vote. IV catheter. Air leaks out of the lung into the space between the lung and the chest wall. Goal is to minimize volutrauma, barotrauma (shear force), atelectatrauma, biotrauma and oxygen toxicity. AaDO2 = PAO2 - PaO2, PaO2 = arterial PO2, PAO2 = alveolar PO2 = FiO2 (713) - PaCO2/0.8. The goal being a MAP equal to or slightly (1-3 cm) below the previous MAP. Perkins R.M. All Rights Reserved. High-frequency ventilation in newborn infants. Pediatrics 114.5 (2004): 1362-364. 3. Many HFOV centers have you order amplitude or delta P (P) to regulate ventilation instead of power. Gerstmann DR, de Lemos RA, Clark RH: High-frequency ventilation: Issues of strategy. It's for newborns who need extra care. Check CXR 1-2 hrs after converting to HFOV, then adjust MAP to achieve optimal lung volume (9 ribs expanded with improved aeration). * Check ABG's every 15-20 min until PaCO2 40-60 or within target range, i.e., titrate Power/Amplitude setting based on PaCO2 desired. It goes through the mouth into the stomach. Pediatrics, 1983;71:483-488. A repeat dose should be given within 4 - 12 hours if the patient is still intubated and requiring more than 30 to 40% oxygen. This isa type of test. Oxygenation on HFJV is directly proportional to MAP which is similar to CMV; however, with HFJV, the MAP should be generated primarily by PEEP with a contribution from the PIP. The term "micro-preemies" is used to describe babies born between 22 and 26 weeks of gestation or smaller than 1 pound 13 ounces. This is a metric unit of volume. Transiently tolerate increased FiO2 requirements (0.6 - 1.0) by reducing MAP as tolerated in order to minimize overdistention from excessive MAP. One piece over bridge of nose and around tube as an in oral intubation. Peer Review Status: Internally Peer Reviewed. TPN (total parenteral nutrition). What does POA stand for in Medical? sexual orientation, gender, or gender identity. This is an open bed with a heating device. This is a feeding tube. Performance of a Lifetime (New York, NY) POAL. Below are words that you will hear used in the NICU. One kilogram is about 2.2 pounds. from BWH NICU therapy staff (PT and SLP): GA at birth <32 weeks Respiratory support at 34 weeks GA . Cath toes Temporary discoloration of a babys toes due to decreased blood flow to the toes, sometimes due to an umbilical artery catheter, Catheter A narrow, flexible tube used to give fluids to the body or to drain fluid from the body. xr$q)z %}! OG tube (orogastric tube). (2) Confirmation of correct PIP should always be determined by appropriate chest wall excursion. prior to the use of Tolazoline to support systemic blood pressure. UC San Diego | School of Medicinetoday = new Date(); document.write("Copyright © ", today.getFullYear()); Hydration during the first days of life and the risk of bronchopulmonary dysplasia in low birth weight infants. Loading Dose - 20 mg/kg/dose of caffeine citrate IV/po, Maintenance Dose - 5 mg/kg/day of caffeine citrate given QD, Maintenance Dose - 6 mg/kg/day divided Q6H/Q8H/Q12H IV/po, Administration - ALWAYS INFUSE SLOWLY over a minimum of 20 minutes. It goes through the mouth or nose into the windpipe. High frequency ventilation. To be used for premature neonates who cant ventilate on high conventional or on excessively high HFJV settings or who require a MAP 20 cm to achieve oxygenation while on HFJV. Choice of Methylxanthine - This decision depends on the clinical situation and should take into account the following factors. Infants requiring increased ambient oxygen concentration, and who are breathing spontaneously, can be placed on NPCPAP. 7. ), Pulmonary interstitial emphysema (PIE) A complication in which there are many tiny tears in the air sacs or small airways of a babys lung, causing air to leak out of them, Pulse oximeter A monitoring device used to show the level of oxygen in a babys blood (This device is taped to the skin, usually a finger or foot, for oxygen level readings. The greater the delta P, the larger the contribution of the PIP to the MAP. Neonates < 34 weeks gestation (NO inhibits platelet aggregation . When lowering the respiratory rate without a concomitant decrease in I:E ratio, the inspiratory time can become quite prolonged. When increasing the respiratory rate above 60/minute, the I:E ratio should be 1:1. In: The Micropremie: The Next Frontier. Chronic lung disease (CLD) is injury or scarring in a preemie or sick infants lungs. 2. (It is a shortening of a Latin term.). This stands for temperature, pulse, and respiration. Subsequent doses are generally withheld if the infant requires less than 30% oxygen. Please note the values for infants <1000 grams. CPAP (continuous positive airway pressure). are at risk of developing persistent pulmonary hypertension of the newborn (PFC) and initially should be closely observed with continuous pulse oximetry for signs of respiratory decompensation and/or right to left shunting, before slowly decreasing their supplemental oxygen while maintaining saturations > 94%. A minimal AMPLITUDE tends to occur around 12-14 units. A baby with RDS is not able to breathe well on his own as small air sacs (alveoli) tend to collapse (atelectasis). ), Dc Medical abbreviation for discontinue or stop, Decadron The trade name for dexamethasone, a steroid drug, Developmental care An approach to caring for premature babies that stresses their individual needs and aims to keep them as free from stress as possible, Developmental delay A delay in reaching certain developmental milestones, relative to most other children of the same age (In preemies, developmental delays may be short term or long term. To maintain body temperature, the infant is placed in an incubator or on a radiant heater bed. Wean delta P by decreasing PIP to keep PaCO2 45 - 60 mm Hg. Inadequate oxygenation (low PO2): Manage by increasing the FiO2, increasing the MAP by increasing the PEEP (i.e. Respiratory therapy andinhaled or IV drugs may be used to relax the lungs tight vessels to help treat this condition. This condition is sometimes seen in premature babies who receive tube feedings for long periods. ATELECTASIS: treat by increasing the rate or PIP of the conventional breaths ("sighs"); INCREASED MOBILIZATION OF SECRETIONS: treat by increasing frequency of suctioning of ETT as needed; HYPOTENSION: treat by lowering MAP by decreasing PEEP, if other methods such as volume and positive inotropic agents have been inadequate. If bagging has to be done, the PIP while bagging if possible should be 8-10 cm above the MAP and a PEEP of 6-8 cm should be maintained as tolerated. If the PaCO2 is elevated, the rate or peak inspiratory pressure can be raised. ), PCO2 (PaCO2) A measure of the carbon dioxide content of the blood, Peripheral IVs IV lines that go into peripheral veins (These veins are the small blood vessels near the skins surface, usually in the babys arms, legs or scalp. Gregory GA, Kitterman JA, Phibbs RH, Tooly WH, Hamilton WK. C. HYPOTENSION- decrease PEEP to decrease MAP to improve venous return if low BP is due to hyperinflation. SIMV (synchronized intermittent mandatory ventilation). ), Esophagus The tube extending from the mouth to the stomach that carries food to the stomach, Exchange transfusion A type of blood transfusion in which the infants blood is removed in small amounts and simultaneously replaced with the same amounts of donor blood, often to dilute harmful concentrations of bilirubin, Extubation The removal of the endotracheal tube, Fine motor skills Skills involving the coordination of the small muscles such as those in the hand, Fontanel The soft spot on the top of the babys head between the un-joined sections of the skull, Fraternal twins Twins formed when two eggs are simultaneously released and fertilized, Full-term (FT) An infant born between the 38th and 42nd weeks of gestation, Gastrostomy A surgically created opening in the abdominal wall to provide nutrition directly to the stomach when the esophagus is blocked or injured, or to provide drainage after abdominal surgery. (Martin et al). While on Infant Star, one observes rapid vibration of the infant's chest wall instead of the normal chest wall excursion that is seen with conventional ventilation. Suction NP tubes as indicated (see Endotracheal Tubes, Suctioning of). Pediatr Clin North Am, 1986;33:221-237. . United States. Inhalational nitric oxide: A selective pulmonary vasodilator for treatment of persistent pulmonary hypertension of the newborn. However, stimulation of these same receptors in the premature infant results in apnea. Pediatrics, 1987;80:409-414. A. This is a breathing machine. HYPOTENSION- decrease PEEP and PIP to decrease MAP, or decrease frequency to minimize air trapping. )JI_p0lIzl3:d9N=~R59tC?ST?Hzz?}]_!?W>4jn_UX}!R[WUw 4N@c[\ ]*q<6~YF$ihocO?Utlf,q8w?7~D>B>c?VSUo?k;ebXcoX!z_CO#B_;2n.~OB]ww;zw;}(Lke]j9u-\1\523=M{:l zMC#Y`hHcF0$Z4oz(MQLZ@7Px`iA5J"AG*U&q^c{U{C/X`z!tp0qRKrb-ucV*?a4lUn.#?yiMQvz?mCS1mswC{=[gcx[L%VHj; ~nZ*9\&s%R{owJ}:7UCw_gCpp/aD .T]H!LfWW'(r0Ohd

Florida Donation Request, Memorial Middle School Assistant Principal, Mother Loses 5 In Fire Gofundme, Top Of The Mountain Showcase Softball Asheville Nc 2021, Articles P