A Practical Approach to Emergencies in the Neonatal Period

Alonso Mata Perez,Manuel Soto Martinez

doi:10.4172/2167-0897.1000213

Abstract

All emergency departments should be prepared to care for a critically ill infant, including having the appropriate sized equipment. The most common diagnosis in admitted neonates include respiratory infections, sepsis, congenital heart disease, bowel obstruction, hypoglycemia and seizures. Febrile neonates are at high risk for sepsis and therefore need blood, urine and CSF testing. These patients should receive empiric antibiotic therapy in hospital. There are many life-threatening illness that can affect this population and is the responsibility of the emergency physician to assess the neonate, stabilize, narrow the differential diagnosis to the most likely and begin life-sustaining treatment. Very different types of illnesses can affect a child in the neonatal period and some can give us different clinical presentation. For example, the spectrum of congenital heart disease presenting in the newborn period and early infancy ranges from benign to catastrophic. Neonatal seizures may have subtle manifestations and require a different approach than seizures in older infants and children. This is a review of the more common but life threatening pathologic conditions in the neonate if not managed adequately.

Highlights

Management of a critically ill neonate in the emergency department (ED) is challenging
The evaluation and appropriate management of the ill neonate requires a deep knowledge of the physiologic changes and life-threating pathologic conditions that may present during this time
A complete blood count with differential (CBC) may be helpful in determining the need for a transfusion in patients with cyanotic congenital heart disease and biochemistry may guide electrolyte replacement or the correction of acidosis

Summary

Introduction

The evaluation and appropriate management of the ill neonate requires a deep knowledge of the physiologic changes and life-threating pathologic conditions that may present during this time. Abnormalities in respiratory rate, heart rate, or blood pressure can be found in any critically ill neonate [2,5,7]. Seizures may indicate abnormalities including glucose and electrolytes levels, central nervous system infections, and metabolic disease or child abuse [8].

Results

Conclusion