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Danger Signs in Newborn

Danger Signs in Newborn. Sick newborn. Early detection, prompt treatment and referral (if required) are necessary to prevent high mortality. Problems in early diagnosis of sick newborn. Non-specific signs Difficulties in preterm and LBW babies. Lethargy and poor sucking.

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Danger Signs in Newborn

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  1. Danger Signs in Newborn DS-

  2. Sick newborn Early detection, prompt treatment and referral (if required) are necessary to prevent high mortality DS-

  3. Problems in early diagnosis of sick newborn • Non-specific signs • Difficulties in preterm and LBW babies DS-

  4. Lethargy and poor sucking • In a term baby who was feeding earlier  indicates neonatal illness (as perceived by mother) • In a preterm baby  needs careful assessment because it may be due to cold stress or immaturity DS-

  5. Capillary refill time (CRT) • Indicates tissue perfusion • Normal CRT < 3 seconds • Prolonged CRT > 3 seconds * • Use 10ml/kg normal saline bolus * Hypotension, hypothermia, acidosis DS-

  6. Capillary refill time (CRT) DS-

  7. Respiratory problems • RR > 60 / min* • Retractions • Grunt • Central cyanosis • Apnea *Rate should be counted in a quiet state and not immediately after feed DS-

  8. R E T R A C T I O N S DS-

  9. 37.5o Normal range 36.5o Cold stress Cause for concern 36.0o Moderate hypothermia Danger, warm baby 32.0o Severe hypothermia Outlook grave, skilled care urgently needed Body temperature in newborn infant (oC) DS-

  10. Failure to pass meconium and urine Failure to pass meconium Majority pass within 24 hrs • Delayed passage • May have passed in –utero • Lubricated per-rectal thermometer may be therapeutic • Suspect obstruction Failure to pass urine Majority pass within 48 hrs • Delayed passage • Exclude obstructive uropathy or renal agenesis DS-

  11. Causes of vomiting* • Ingestion of meconium stained amniotic fluid • Systemic illness • Congestive cardiac failure • Raised ICP – IVH, asphyxia • Metabolic disorders (CAH, galactosemia) *Persistent, projectile or bile stained - r / o intestinal obstruction DS-

  12. Causes of diarrhea • Infective diarrhea* (often non breast fed baby) • Maternal ingestion of drugs (ampicillin, laxatives) • Metabolic disorders • Thyrotoxicosis • Maternal drug addiction *Infective diarrhea needs treatment with systemic antibiotics DS-

  13. Cyanosis Peripheral • Normal at birth • Seen in extremities due to cold Central • Always needs appropriate referral • Seen on lips and mucosa • Indicates cardiac or pulmonary disease DS-

  14. Peripheral cyanosis DS-

  15. Central cyanosis DS-

  16. Yellow Palms & Soles DS-

  17. Yellow staining of soles DS-

  18. Tracheo-esophageal fistula • Excessive drooling; choking; cyanosis during feeds; respiratory distress • Failure to pass red rubber catheter beyond 8 to 10 cm from mouth DS-

  19. Tracheo-esophageal fistula DS-

  20. Suspect cardiac disease • Cyanosis • Tachycardia • Murmur • Hepatomegaly • Shock • Cardiomegaly DS-

  21. Abnormal weight loss pattern • > 10 percent of birth weight in term • > 15 percent in preterm • > 5 percent acute weight loss DS-

  22. Danger signs : Summary • Lethargy • Hypothermia • Respiratory distress • Cyanosis • Convulsion • Abd. distension • Bleeding • Yellow palms/ soles • Excessive wt. loss • Vomiting • Diarrhea DS-

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