Contents Chapter Topic Page Neonatology Respiratory Cardiology

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Special Circumstances in Resuscitation of the Newly Born Infant Condition History/Clinical Signs Actions Meconium or mucus blockage Mechanical blockage of the airway Meconium-stained amniotic fluid. Poor chest wall movement. Choanal Atresia Pink when crying, cyanotic when quiet Pharyngeal airway Persistent retractions, poor malformation air entry Impaired lung function Pneumothorax Asymmetrical breath sounds. Persistent cyanosis / bradycardia Pleural effusion / ascites Diminished air movement. Persistent cyanosis / bradycardia Congenital diaphragmatic hernia Asymmetrical breath sounds. Persistent cyanosis/bradycardia. Scaphoid abdomen Pneumonia/sepsis Diminished air movement. Persistent cyanosis / bradycardia Impaired cardiac function Congenital heart disease Persistent cyanosis / Foetal / maternal haemorrhage bradycardia Pallor; poor response to resuscitation Intubation for suctioning / ventilation Oral airway. Endotracheal intubation Prone positioning, posterior nasopharyngeal tube Needle thoracentesis Immediate intubation. Needle thoracentesis, paracenteris. Possible volume expansion. Endotracheal intubation. Placement of orogastric catheter Endotracheal intubation. Possible volume expansion Diagnostic evaluation Volume expansion, possibly including red blood cells. Reference: 1. Textbook of Neonatal Resuscitation from the American Academy of Paediatrics and AHA 2000. 2. International Guideline for Neonatal Resuscitation Consensus (PEDIATRICS Vol. 106 No. 3 September 2000).
Definition Premature infant: < 37 weeks gestation THE PREMATURE INFANT Low Birth Weight (LBW): < 2500 g Very Low Birth Weight (VLBW): < 1500 g Extremely Low Birth Weight (ELBW): < 1000 g Small for Gestational Age: < 10th centile of Birth Weight for age. Complications in premature infants a) Perinatal Asphyxia b) Hypothermia c) <strong>Respiratory</strong> (RDS and apnoea) d) CVS (Hypotension, PDA) e) Neurological: Intraventricular haemorrhage and Periventricular leukomalacia f) Gastrointestinal (Paralytic ileus, NEC) g) Hypoglycaemia and hyperglycaemia h) Neonatal Jaundice i) Hypoprothrombinaemia j) Fluid and Electrolyte imbalance (hyponatraemia, hyperkalemia, metabolic acidosis) k) Anaemia l) Neonatal Sepsis m) Rickets n) Oxygen therapy: ROP, CLD o) Neuro-developmental disabilities p) Psychosocial problems Management A. Before and During Labour Prewarmed incubator and appropriate equipment for neonatal intensive care should always be kept ready in NNU. B. Adequate Resuscitation C. Transfer from Labour Room (LR) to NNU (Neonatal Unit) a) Use prewarmed transport incubator if available. If not the baby must be wiped dry and wrapped in dry linen before transfer. b) If the infant's respiration is inadequate, keep the infant INTUBATED and AMBUBAGGED with oxygen during the transfer. D. Admission Routine - Ensure thermoneutral temperature for infant. An incubator or radiant warmer is necessary for more premature and ill babies. - Ventilation is often necessary if ventilated during transfer. - If oxygen saturation is < 90%, oxygen therapy should be given. - Head circumference (OFC), length measurements and bathing can be omitted. - Quickly and accurately examine and weigh the infant.
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 and 32: AGE Gross Motor Vision & Fine Motor
Page 33 and 34: Principles of Transport of the Sick
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: Summary: Use of medications during
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
Page 99 and 100: - 1ml of 4.2% NaHCO3 given for ever
Page 101 and 102:
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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