Neonatal OSCE Flashcards
What does DRABCDE stand for?
D - Danger R - Response A - Airway B - Breathing C - Circulation D - Disability E - Environment / Exposure
What are the three sections of the paediatric triangle?
- Work of breathing
- Circulation to skin
- Appearance
What are you going to look for when assessing the work of breathing?
- Patient positioning
- ICS/Sub/Supra sternal recession
- Audible sounds
- Nasal flaring
What are you going to look for when assessing circulation to skin?
- Cyanosis
- Pallor
- Mottling
- Mucus membranes
What is the algorithm to use when assessing appearance?
TICLS
What does TICLS stand for? Give examples of what to look for each.
Tone - Muscle tone, rigidity, floppy
Interactiveness - Use AVPU, following objects with eyes, grasps objects, uninterested
Consolability - Can be consoled by parent/guardian/carer or inconsolable
Look/Gaze - Fixes gaze on face, vacant/glassy eyed stare
Speech/Cry - Weak, muffled, horse
What questions to ask when accessing feeding?
Is the baby interested when offered breast/bottle or are they sleepy?
Does the baby attach to the breast/bottle?
Is the baby taking all of the feed?
Do you need to wake the baby up to feed?
How often should neonates feed?
Neonates are expected to feed every 3 hours, 8-10 feeds in 24 hours.
(Pre-term babies may need to be woken up for a feed)
How many wet nappies should neonates have?
At least 5 heavy, wet nappies in 24 hours
How many soiled nappies should neonates have?
Minimum of 2 dirty nappies in 24 hours (except in days 1 + 2 where 1 is okay)
What is Volvulus?
This is where the bowel twists on itself causing an obstruction within the bowel, which can also cause the obstruction of the blood supply within the intestine.
What are the symptoms of Volvulus?
Vomiting (Looks like bile), abdominal pain/tenderness (positioning), bloody or dark red stools, constipation, distention
What is intussusception?
Intussusception is when the bowel goes in on itself like a ‘telescope’ which causes the bowel walls to press on one another, therefore, blocking the bowel. This can lead to reduced blood flow to that part of the bowel.
What is the symptoms of Intussusception?
Intermittent abdominal pain, between intervals, child can look pale, tired and floppy. Possible to palpate an abdominal mass. Red-currant jelly stools. Bile stained vomit is a late sign. May present as hypovolaemic shock.
What is pyloric stenosis?
Pyloric stenosis is the abnormal narrowing of the outlet to the stomach to the small intestine, therefore blocking food/fluid to be digested.
