Case

  • 12 day-old boy is brought to the ED with rapid breathing and not feeding well.
  • Breastfeeding well until 2 days ago. Since then, decreased feeding, vomiting every other feed for the last 2 days. Over the last several days, had 3 wet diapers over the last 24 h.
  • Term baby, normal pregnancy, spontaneous vaginal delivery, spent 2 days in the hospital with mother. He had an uneventful course including circumcision.

Objectives:

  • Managing an ill-appearing neonate
  • Discuss management of a cyanotic neonate
  • Management of hypoglycemia
  • Practice effective teamwork, closed-loop communication, and situational awareness.

Checklist

Reading Material

2020 Neonatal Rapid Response Algorithm

2016 NRP Algorithm

2011 Medications Table

Supplemental Reading Material

TREKK Approach to cyanotic congenital heart disease in the newborn (2013)

An Emergency cases podcast: Part 1

CPS guidelines for Pulse oximetry Screening in Newborns

TREKK Clinical Practice Guideline: Resuscitation of blue baby and the use of prostaglandins (2010)

An Emergency cases podcast: Part 2