CAPSULE cases

Question 1

Important questions to ask if a 10d old baby isn’t feeding well.

Answer 1

Maternal illness + GBS status
Wet nappies - hydration status
Waking for feedings - drowsiness

Question 2

What signs are indicative of cardiovascular compromise in a baby?

Answer 2

Cold peripheries
Mottled appearance

Question 3

How would you assess hydration status using palpation (of the head)?

Answer 3

Anterior fontanelle - is it sunk - dehydration

Question 4

If the anterior fontanelle was tense, what would this suggest?

Answer 4

Raised intracranial pressure

Question 5

Investigations if you are concerned about infection in a baby

Answer 5

Bloods, including culture
Urine analysis and culture
LP

Question 6

A baby is query septic in A&E. How would you manage?

Answer 6

IV access
Bolus fluid of normal saline
IV antibiotics
Maintenance fluids
THEN transfer to inpatient area

Question 7

Most likely cause of sepsis in a newborn

Answer 7

Group B strep