term admissions to NNU Flashcards
What are the symptoms of sepsis in infants
- Pyrexia or hypothermia
- Poor feeding
- Lethargy
- Early jaundice
- hypo or hyperglycaemia
- Floppy
- Asymptomatic
What is the investigations done of presumed sepsis in a newborn
- Partial septic screen (FBC, CRP and blood cultures) and blood gas
- Consider Chest X ray and lumbar puncture
What is the most common causes of neonatal sepsis
- Group B strep
- E.coli
- Listeria
- Coag-negative staphylococci
- Haemophilus influenza
What is the management of presumed sepsis
- IV penicillin and gentamicin
- IV vancomycin and gentamicin
- Add metronidazole if concerns
Fluid management and treat acidosis
What is the presentation of Group B streptococcus sepsis
- Early onset within first week
- Late onset up to 3 months
- Non-specific symptoms
What are the most common congenital infection
TORCH
T- Toxoplasmosis
O - other
R - Rubella
C - Cytomegalovirus
H - Herpes simplex virus
What is the presentation of TTN - Transient tachypnoea of the newborn
- Self limiting
- Presents within 1st few hours
- Grunting
- Tachypnoea
- O2 requirement
What is the management of transient tachypnoea of the newborn
- Supportive
- Antibiotics
- Fluids
- O2
- Airway support
What is Transient tachypnoea of the newborn associated with
- C section
What is a key sign on Xray of TTN
Fluid in the horizontal fissure
What is meconium aspiration
Meconium is inhaled into the lung due to the infant excreting the meconium during labour so it passes into the amniotic fluid
What is the presentation of meconium aspiration
- Cyanosis
- Increased work of breathing
- Grunting
- Apnoea
- Floppiness
What is the treatment of a meconium aspiration
- Suction below cords with endotracheal tube
- Intubation and ventilation
- Fluids and antibiotics
- Surfactant
What is the management of hypoglycaemia in a new born
- Monitor blood glucose
- Start IV 10% glucose
- Increase glucose concentration as needed
- Glucagon if severe
- IV hydrocortisone if most severe
What is the management of hypothermia
- If unable to mantain temperature on post natal ward - place in incubator
- Sepsis screen and antibiotics
- Check thyroid function tests
- Monitor blood glucose
What causes birth asphyxia
Lack of oxygen at around birth which leads to multiorgan dysfunction
Describe the stages of birth asphyxia
- Within minute - cell damage due to lack of blood flow
- Reperfusion injury that can last days or weeks due to toxins which are released from damaged cells
What is the management of Hypoxic ischaemic encephalopathy
- Therapeutic hypothermia
- Treat seizures
What is neonatal abstinence syndrome
Withdrawal from physically addictive substances taken by the mother in pregnancy
What is the treatment of neonatal abstinence syndrome
- Comfort
- Morphine
- Phenobarbitone
