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CASE 1 Paedatric Emergency. 6 hours / Neonate Born to a mother from rural background No homoeopathic orientation. Call received at 1 am in the night for stabilizing a neonate having respiratory distress and convulsions immediately after birth following difficult labor.
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CASE 1 Paedatric Emergency 6 hours / Neonate Born to a mother from rural background No homoeopathic orientation Call received at 1 am in the night for stabilizing a neonate having respiratory distress and convulsions immediately after birth following difficult labor.
CASE 1 Paedatric Emergency A/F: BIRTH TRAUMA + BIRTH ASPHYXIA PRESENTATION NO AURA ICTAL PHASE- BITING LIPS TWITCHING FACE DISTORTION FACE HEAD ROLLING TO SIDES TONIC CLONIC MOVEMENTS OF EXTREMITIES CLENCHED FIST POST ICTAL – PROSTRATION PUPILS DILATED
CASE 1 Paedatric Emergency Examination: General condition: Poor Peripheral cyanosis Heart rate: 160 / minute Heart sounds Normal Respiratory Rate: 60/ minute Conducted sounds and crepitation CNS: Generalized tonic - colonic movements of upper and lower extremities, facial distortion and frothing at mouth Hyper tonic spasm Plantars extensor Investigation : Serum Glucose : Normal Serum Calcium : Normal
STRUCTURE TIME FORM FUNCTION
CASE 1 Paedatric Emergency Brain Oedma and Hypoxia 6 hours Cerebral irritation A/F: Birth Trauma and asphyxia Convulsions Status epilepticus Facial distortion
CASE 1 Paedatric Emergency TOTALITY A/F: Cerebral Concussion Facial distortion Pupils dilated Head turning sides Prostration CICUTA SUSCEPTIBILITY ASSESSMENT Pace of disease : Rapid Pathology : Acute Oedma of brain Vitality : Compromised Characteristic : Present Correspondence : Adequate 200 C frequently 1 hrly---4 hrly
CASE 1 Paedatric Emergency Ancillary measures Continuous Oxygen Radiant warmer Intermittent Naso – Oral Suction Naso gastric Intubations Intra Venous fluids
FOLLOW UP CASE 1 Paedatric Emergency CHILD RELAXED 1st hr. Convulsions better in Freq. 2nd hr. Convulsions better 50% 5th hr. Convulsions better 75% Only facial twitching Child appeared PEACEFUL 8th hr. Convulsions – NIL 24th hr. CHILD ACTIVE
Conclusion • Long term evaluation and management of this child would only require constitutional treatment. • The possible long-term brain damage was contained and cured within 24 hours, quite a feat considering that this child may not have survived at all!