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MBChB Surgery > Transport of the neonate with bowel obstruction > Flashcards

Transport of the neonate with bowel obstruction Flashcards

1
Q

Give the acronym for preparing a newborn for transport

A

TWO SIDES

Tube
Warmth
Oxygen
Stabilise
IV fluids
Documents
Escort
Specimens
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2
Q

Name the functions of the nasogastric tube in transport of the neonate with bowel obstruction

A 
Relieve symptoms
Prevent vomiting
Prevent aspiration
Improve ventilation
Measure fluid loss
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3
Q

Which bodily fluids indicate which levels of obstruction?

A

Saliva - oesophageal
Milk - stomach outlet
Bilious - post Ampulla of Vater

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4
Q

Explain the role of oxygen in transport of the neonate with bowel obstruction

A

Supports respiration

Combats anaerobic infections

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5
Q

Below what level should the oxygen be in transport of the neonate with bowel obstruction and why?

A

<40%

Prevent eye complications

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6
Q

Give the amounts of maintenance fluids for full term babies

A

Day 1: 60ml/kg/24h
Day 2: 90ml/kg/24h
Day 3: 120ml/kg/24h
Day 4: 150ml/kg/24h

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7
Q

What documents should be provided in transport of the neonate with bowel obstruction

A

Referral letter
Consent (operation, blood transfusion, contrast)
Contact details

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8
Q

What diagnosis is a neonate with bilious vomiting until proven otherwise?

A

Bowel obstruction - surgical emergency!

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9
Q

Name causes of neonatal bowel obstruction

A

Atresia
Hirschsprung’s
Volvulus
Meconium ileus

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10
Q

Name maternal risk factors for neonatal small bowel obstruction

A

Diabetes
Medication
Age
IU infection

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11
Q

How is neonatal bowel obstruction diagnosed prenatally?

A

On sonar:
Polyhydramnios
Distended fluid-filled GIT

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12
Q

Name clinical features of neonatal small bowel obstruction

A

Vomiting
Abdominal distention
No meconium passed

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13
Q

What is the most common type of small bowel atresia?

A

Duodenal atresia

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14
Q

Name malformations associated with duodenal atresia

A

T21 syndrome

VACTERL

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15
Q

Discuss treatment of duodenal atresia

A

Resus

Duodeuno-duodenostomy

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16
Q

What does bloody mucous from the rectum indicate in suspected volvulus?

A

Necrotic bowel

17
Q

Which condition is associated with meconium ileus?

A

Cystic fibrosis

18
Q

Which condition can meconium ileus look like?

A

Hirschsprung’s

19
Q

What type are the majority of oesophageal atresias?

A

Proximal atresia with distal tracheal fistula

20
Q

How is oesophageal atresia diagnosed?

A 
Vomiting with the FIRST feed
3Cs
- choking
- coughing
- cyanosis
NGT curling up
21
Q

Discuss management of an oesophageal atresia

A

Thoracotomy
Division and suture of TOF
Oesophageal anastomosis

MBChB Surgery (38 decks)

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