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The Sick Neonate - Coggle Diagram
The Sick Neonate
Investigations
Hb
neutrophils
platelets
U+E
creatinine
lactate
cultures - blood / CSF / urine
glucose
CRP
coag screen
Monitoring
O2 sats
maintain @ 88-95% if preterm
HR
RR
temp
BP
glucose
blood gases
weight
Birth injuries
common if infant is malpositioned or too large for pelvic outlet
Caput succedaneum
cephalhaematoma
Chignon (ventouse)
subgaleal haematoma
Nerve palsies
Brachial plexus
C5-6: Erb's
may be a/w phrenic N palsy causing elevated diaphragm
Klumpke's
Facial N
Most resolve completely by 2 yrs
Refer to surgeon if not resolved by 2-3mo
fractures
clav
humerus
femur
Airway & Breathing management
Signs of resp distress
tachypnoea
laboured breathing
chest wall recession
nasal flaring
expiratory grunting
cyanosis
apnoea
clear airway
O2
CPAP
mechanical ventilation
Venous & Art lines
Peripheral IV line
for IV fluids, antibiotics, other drugs
Umbilical venous catheter (UVC)
for high conc dextrose, inotropes
Umbilical art catheter (UAC)
for frequent blood gas analysis, continuous BP monitoring
Central venous line
for parenteral nutrition
switch to peripheral once infant stable
Types of care
Special care
Short term intensive care
Long term intensive care
May need to do CXR +/- PFA
helps dx resp disorders
confirms position of EET / central lines
Temp control
perform stabilisation under radiant warmer/humidified incubator to avoid hypothermia
Antibiotics
broad spectrum until cultures come back
Minimal handling
adversely affects oxygenation + circulation
NB to keep parents informed