Contents Chapter Topic Page Neonatology Respiratory Cardiology

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AGE Gross Motor Vision & Fine Motor Speech & Language Personal Social 5 years Skips on both feet. Copies ‘X’ (5 years) Knows AGE. Ties shoelaces. Runs on toes. Names 4 colours. Dresses and undresses Copies (5½ years) triangle. Triple order preposition. alone. Goodenough test 8. Tell time. 6 years Walks heel to toe Kicking, throwing, climbing. Copies Goodenough test 12. Imitates or copies steps with 10 cubes: 1. Goodenough test: 3 + a/4 years (a = each feature recorded in his picture). 2. 10% still not dry by day or night at 5 years. 3. Draw the following: 8 years 10 years 12 years.
Principles of Transport of the Sick Neonate • Transport of neonates involves pre-transport intensive care level resuscitation and stabilisation and continuing intra-transport care to ensure that the child arrives in a stable state. • Organized neonatal transport teams bring the intensive care environment to critically ill infants before and during inter-hospital or intra-hospital transport. • The basis of a safe and timely transport is good communication and coordination between the referring and receiving hospital to ensure adequate stabilisation pre-transport and continuing intra-transport care. • There is a rare need for haste. • There must be a balance between anticipated clinical complications that may arise due to delay in definitive care and the benefits of further stabilisation. 1. Special Considerations in Neonates Apnoea – Premature and septic babies are especially prone to apnoea Bradycardia – In the newborn, hypoxia causes bradycardia followed by heart block and asystole Oxygen toxicity to the lungs and retina - especially important in the premature baby Reversal to fetal circulation (Persistent pulmonary hypertension of the neonate PPHN) – Can be precipitated by hypoxia, hypercarbia, acidosis and sepsis Hypothermia – The mechanisms of thermoregulation are less developed and the child has a larger body surface area: mass ratio. Non shivering thermogenesis is induced by the oxidation of brown fat. If the bowels are exposed, the heat and fluid loss are compounded by evaporation. The effects of hypothermia are acidosis and subsequent Primary Pulmonary Hypertension, impaired immune function and delayed wound healing. Hypoglycemia – The neonate lacks the glycogen store in the liver and fat deposits. Jaundice – worsen in the baby with sepsis or intestinal obstruction. 2. Mode of transport Careful consideration must be made as to the mode of transport. • The best mode of transfer is “in utero” as far as possible. E.g. a mother in premature labour should be managed in a centre with NICU facilities or if a surgical anomaly has been detected antenatally, the mother should be advised to deliver at a centre with paediatric surgical facilities. • For post natal transfers, the advantages and disadvantages of road, air (helicopter / commercial airlines) and riverine transport must be considered in each child. If air transport is chosen, then the effects of decreased atmospheric pressure on closed cavities and the lack of working space must be taken into account. Transport incubators with monitors, ventilators and suction equipment are ideal. 2.1 Air Transport A number of patients are transported by either the commercial airlines with pressurised cabins flying at higher altitudes or by helicopters flying at lower altitudes but without pressurised cabins. There are special problems associated with air transport:
Page 1 and 2: Contents Chapter Topic Page 1 Norma
Page 3 and 4: Dermatology 67 Atopic Dermatitis…
Page 5 and 6: Dato’ Dr. Lim Nyok Ling Consultan
Page 7 and 8: ISSN 1823-3856 Printed by: Perniaga
Page 9 and 10: Foreword One of the maxims of scien
Page 11 and 12: B. Anthropometric Measurements a) H
Page 13 and 14: Immunisation 1. Immunisation schedu
Page 15 and 16: 2 General Notes 2.1 Many vaccines (
Page 17 and 18: 3.5.6 Rubella - Contraindicated in
Page 19 and 20: 4.8 Rubella May have rash, fever,
Page 21 and 22: 5.5 Close contacts of immuno-defici
Page 23 and 24: Developmental Assessment Developmen
Page 25 and 26: Hearing Assessment Warning signs fo
Page 27 and 28: Global Developmental Delay History
Page 29 and 30: Developmental Milestones Table AGE
Page 31: AGE Gross Motor Vision & Fine Motor
Page 35 and 36: 3.1 Airway Management Establish a p
Page 37 and 38: 3.7 Environment Neutral Thermal Env
Page 39 and 40: 7. Special Surgical Conditions 7.1
Page 41 and 42: • Ventilation - Most of the babie
Page 43 and 44: Neonatal Resuscitation High Risk De
Page 45 and 46: • Drugs are available (and prepar
Page 47 and 48: Meconium stained liquor: Meconium i
Page 49 and 50: Summary: Use of medications during
Page 51 and 52: Definition Premature infant: < 37 w
Page 53 and 54: 8. Supplements: a. At birth : Vitam
Page 55 and 56: Enteral Feeding in Neonates 1. Intr
Page 57 and 58: 32 weeks Well babies Start milk imm
Page 59 and 60: Total Parenteral Nutrition for Neon
Page 61 and 62: Clearance is usually monitored by m
Page 63 and 64: Daily weight Meticulous care of th
Page 65 and 66: Monitor BUSE and correct any imbala
Page 67 and 68: C. UAC and UVC care UAC position Le
Page 69 and 70: HIGH FREQUENCY OSCILLATORY VENTILAT
Page 71 and 72: 6. Infants must be monitored closel
Page 73 and 74: pH , PaCO2, PaO2, HCO3 - , Bases Ex
Page 75 and 76: Q. Name a likely diagnosis A. RDS 3
Page 77 and 78: A. Definition Birth Asphyxia There
Page 79 and 80: E. Management I. Good intrapartum c
Page 81 and 82: c. All doctors managing such infant
Page 83 and 84:
Etiology Determination of etiology
Page 85 and 86:
FLOW CHART: MANAGEMENT OF NEONATAL
Page 87 and 88:
2. Klauss & Fanaroff: Care of The H
Page 89 and 90:
D. Asymptomatic Hypoglycaemia Feed
Page 91 and 92:
NEONATAL JAUNDICE What is jaundice?
Page 93 and 94:
Physical examination • General co
Page 95 and 96:
Once the baby is on phototherapy, v
Page 97 and 98:
Reference: extracted from MOH publi
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- 1ml of 4.2% NaHCO3 given for ever
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a. If unconjugated hyperbilirubinae
Page 103 and 104:
APNOEA IN THE NEWBORN Definition :
Page 105 and 106:
History NEONATAL SEPSIS Septic Neon
Page 107:
Antibiotic choice will depend on pr
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Contents Chapter Topic Page Neonatology Respiratory Cardiology

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