Sick term infant Flashcards
when might a neonate become unwell?
at delivery
first few hours
first few days
up to 28 days
Apgar score
heart rate 2 resp effort 2 tone 2 colour 2(pink/blue/white/ jaundiced) response 2 total 10 other- bilious vomiting,poor vomiting
new born clinical assessment
history- maternal hx- PMH,pregnancy issues, drugs, infection risk infant hx- fetal growth, fetal anomaly, delivery, resuscitation inspection -tone (poor, floppy) -level of arousal -colour Vitals - heart rate (140-160bpm) - respiratory rate(40-60)
Initial management of sick infant
temperature airway & breathing- oxygen? circulation- fluids inotropes? Metabolic homeostasis glucose management acid-base balance? Antibiotics
further support
ventilation drugs surgery transfer? specific therapy- eg therapeutic cooling
causes of sick baby
congenital anomalies
metabolic
infection
pregnancy/birth related
infection can happen
antenatal perinatal postnatal causes - bacterial viral fungal
sites of infection
blood stream- bacteraemia/ septicaemia
CNS- meningitis
respiratory- pneumonia
GU tract- UTI
common bacteria spp
Group B strep E. Coli Listeria myocytogenes staphylococcus aureus staph epidermidis
common viral infections
cytomegalovirus
parvovirus
herpes virus
enterovirus
pregnancy/birth related issues
hypoxic ischemic encephalopathy transient tachypnoea pnumothorax heart failure- hydrops foetalis failure to adapt- persistant pulmonary hypertension(PPH)
hypoxic ischemic encephalopathy
multi organ damage low apgar score- resus required
neurodevelopmental issues
congenital diseases of the heart
Tetralogy of Fallot Transposition of great arteries Coarctation of the aorta TAPVD Hypoplastic heart
congenital diseases of the respi tract
tracheo-oesophageal fistula
diaphragmatic hernia
other major congenital issues
Neurological Microcephaly Spina bifida Renal Potters syndrome Muscular Myotonic dystrophy
