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10 Cards in this Set
- Front
- Back
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Neonatal bleeding management |
1. Stop active bleeding 2. Treat shock as an emergency 3. Secure umbilical catheterization 4. Normal saline 10ml/kg/bolus over 20 minutes 5. Whole blood 20ml/kg IV over 3-4 hours to correct anemia and hypovolemic shock 6. Fresh frozen plasma 10ml/kg 3-4 hours to correct bleeding and hypovolemia 7. Vitamin K 5mg IM or IV stat 8. Platelet concentrate 1U IV slowly in case of thrombocytopenia |
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Neonatal hypoglycemia management |
1. Identify cause 2. Breast milk or formula milk oral feeding every 2 hours for asymptomatic neonates 3. 10% DW 2ml/kg IV 4. Maintain glucose supply 6-8mg/kg/min 5. Increase concentration to 12mg/kg/min if no improvement in plasma glucose level 6. Start hydrocortisone or glucagon in persistent and resistant hypoglycemia |
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Neonatal hypothermia management |
1. Active warming (internal warming): - Warm IV fluids - Warm humidified oxygen
2. Passive (external warming): - Adequate body clothing - Radiant heater or incubator; heater blanket - Correct hypotension using normal saline - Treat concomitant sepsis and hypoglycemia - Keep under thermo-neutral environment |
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Exchange transfusion in neonatal jaundice |
- Most important and effective method - Umbilical vein catheterization - Double volume blood exchange (2 X 80ml/kg) - The procedure washes 87% of the total blood - Reduces jaundice by 40-60% of pre-exchange level - It removes bilirubin, hemolyzed blood, Igs, and bacteria
Complications: - Volume overload - Electrolytes imbalance - Acid base disorder - Blood clotting, embolization, and infections |
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Phototherapy in neonatal jaundice |
*Bilirubin absorbs light in blue range wavelength (425-475nm) - Structural isomerization (cyclization) to Limirubin. Fast reaction and irreversibility so most important method - Photo-isomerization from 4Z, 15Z to 4Z, 15E but it is reversible back to its original isoform - Photo-oxidation: least important as it is a slow process
Complications: - Insensible water loss - Loose stools - Eye injury - Bronze baby syndrome |
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Neonatal sepsis management |
1. Admit pt to NICU 2. Keep maintenance fluid 10% DW on 1st day then to 10% DW and 1/3rd NS from next day onwards 3. Amoxicillin 200mg/kg/day in two divided doses 4. Gentamicin 3.5mg/kg/day IV 5. Oxygen support; correct hypoglycemia 6. Keep under radiant heater or incubator 7. Feeding of breast milk via NG tube or cup feeding 8. Fresh frozen plasma for DIC or shock |
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Neonatal Tetanus management |
1. Control spasms: Diazepam, silent room 2. Control toxin: TAT, human antitoxin 3. Eradicate C. tetani: Metronidazole or Crystalline penicillin 4. Wound care: debridement and cleaning 5. Supportive care: oxygen, IV fluids, NGT feeding, correct electrolytes 6. Tracheostomy: for airway obstruction |
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Management of prematurity |
1. Temperature regulation: Incubator, KMC, radiant heater 2. Maintenance fluid: Slowly increase from 60 to 150ml/kg/day 3. Feeding: - Tophic feeding (small amounts to prime GIT) - Gavage feeding: NGT (use breast milk) - Expressed breast milk cup feeding 4. Treat sepsis: Ampicillin + Gentamicin 5. Treat accompanying complications |
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Complications of prematurity |
1. CNS: perinatal asphyxia, apnea, intracranial bleeding, cerebral palsy, mental retardation 2. Hematology: anemia, polycythemia, bleeding, jaundice 3. GIT: NEC, feeding difficulty 4. Renal: Edema, electrolyte imbalance 5. Respiratory: RDS, congenital pneumonia, apnea 6. Immunology: Deficiency of WBC and Ig and C level 7. Metabolic: Hypoglycemia, hypothermia 8. CVS: Hypotension, PDA |
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TORCH infection Rx |
- Syphilis: Penicillin. Mother and her partner should also be treated - Toxoplasmosis: Spiramycin for the mother; Pyrimethamine/Sulfadoxine for the baby - CMV, HSV, HZV: Acyclovir or Ganciclovir - Mgt of complications like hydrocephalus, CHD, cataract, etc.. require surgical intervention |
