Neonatal Emergencies

by Edited by Georg Hansmann

• ISBN13: 9780521701433
• ISBN10: 0521701430
• Edition: 1st
• Format: Paperback
• Copyright: 2009-11-30
• Publisher: Cambridge University Press

Summary

Covering the management of critically ill newborns from the first minute of life through the first 72 hours, this practical, evidence-based and clinically-informed guide will provide all members of the pediatric care team with the essential information to save lives and prevent disability. With chapters on neonatal transport, resuscitation, ventilation and ethical issues, the content is further illustrated with case studies illustrating the real-world aspects of identifying critical signs and symptoms, diagnostics and treatment in multiple settings. As well as including numerous clear diagrams and summary tables, the text includes algorithms based on international guidelines to help navigate the reader through the delivery of care, and a comprehensive listing of drugs and dosages, serving as a quick reference guide when making treatment decisions. This is essential reading for pediatric residents, fellows and junior faculty, neonatal intensive care nurses, paramedics, obstetricians, midwives, anesthesiologists and emergency medicine physicians.

Table of Contents

List of contributors	p. xii
Foreword (1)	p. xiii
Foreword (2)	p. xv
Preface	p. xvii
Acknowledgments	p. xix
Organization of neonatal transport
History and challenges of neonatal emergency transport services (NETS)	p. 1
Interdisciplinary approach for neonatal emergencies	p. 5
Neonatal emergency call: what the neonatology team would like to know from obstetricians and midwives	p. 9
Coordinating health care providers after a neonatal emergency call	p. 11
What the neonatologist would like to find in the delivery room	p. 13
What the neonatologist does not want to find in the delivery room	p. 15
Definitions and abbreviations in neonatology, pediatric cardiology, neonatal emergency transport service (NETS), and obstetrics	p. 16
References (Section 1)	p. 24
Basics in cardiopulmonary resuscitation of newborn infants
Basic equipment setup for initial neonatal care and resuscitation	p. 25
Drugs for neonatal emergencies	p. 41
Postnatal cardiopulmonary adaptation	p. 63
ABC techniques and procedures
Suctioning	p. 67
Stimulation, oxygen supplementation, bag-and-mask ventilation (M-PPV), pharyngeal/bi-nasal CPAP, and pharyngeal positive pressure ventilation	p. 71
Endotracheal intubation and gastric tube placement	p. 82
Laryngeal mask airway (LMA)	p. 96
Chest compressions	p. 101
Peripheral venous access	p. 105
Umbilical vein/artery catheterization (UVC, UAC)	p. 107
Central venous access (internal jugular vein)	p. 112
Intraosseous access	p. 117
Cord clamping	p. 121
Management of high-risk infants in the delivery room	p. 124
Monitoring in the delivery room and during neonatal transport	p. 131
Hygiene in the delivery room and during neonatal transport (infection control)	p. 133
When to call a pediatrician to the delivery room	p. 134
Checklist for the postnatal treatment of newborn infants	p. 136
Assigning individual duties in the delivery room	p. 140
Clinical assessment of the newborn infant	p. 142
Cardiopulmonary resuscitation of newborn infants at birth	p. 150
Volume therapy and sodium bicarbonate supplementation in preterm and term newborn infants	p. 173
Absolute and relative indications for neonatal transport and NICU admission	p. 179
Communication with mother and father	p. 181
Coordinating neonatal transport and patient sign-out to the NICU team	p. 182
Documentation and feedback after neonatal emergency transport	p. 183
Ethics in neonatal intensive care	p. 184
Perinatal images of preterm and term infants	p. 191
Mechanical ventilation of the neonate	p. 193
Questions for review (basics)	p. 210
References (Section 2)	p. 212
Classic and rare scenarios in the neonatal period
Management of healthy, term newborn infants (vaginal delivery, cesarean section, vacuum extraction, forceps delivery)	p. 221
Management of preterm and moderately depressed term newborn infants with a birth weight ≥ 1500g	p. 227
Management of very preterm newborn infants (VLBW, ELBW)	p. 231
Twin-twin (feto-fetal) transfusion syndrome	p. 240
An apparently trivial call from the term baby nursery	p. 243
Out of hospital birth	p. 249
Hypoglycemia	p. 260
Meconium aspiration	p. 269
Chorioamnionitis and early-onset sepsis in the newborn infant	p. 280
Perinatal hemorrhage	p. 304
Perinatal hypoxia-ischemia	p. 310
Cerebral seizures	p. 317
Infants born to mothers on psychoactive substances	p. 322
Prenatal and postnatal arrhythmias	p. 325
Critical congenital cardiovascular defects	p. 340
Patent ductus arteriosus of the preterm infant	p. 380
Persistent pulmonary hypertension of the newborn (PPHN)	p. 392
Congenital diaphragmatic hernia	p. 404
Pneumothorax	p. 410
Congenital cystic adenomatoid malformation of the lung (CAM, CCAM)	p. 417
Chylothorax	p. 419
Hemolytic disease of the newborn	p. 423
Hydrops fetalis	p. 427
Choanal atresia	p. 432
Esophageal atresia	p. 434
Gastrointestinal obstruction	p. 437
Necrotizing enterocolitis (NEC)	p. 447
Omphalocele and gastroschisis	p. 450
Neural tube defects	p. 455
Cleft palate	p. 460
Birth trauma: brachial plexus palsy, facial nerve palsy, clavicular fracture, skull fracture, intracranial and subperiosteal hemorrhage (cephalohematoma)	p. 464
Sudden infant death syndrome (SIDS)	p. 468
Questions for review	p. 472
References (Section 3)	p. 477
Transport
Transport of preterm and term infants	p. 493
Acute antenatal transfer	p. 504
Questions for review	p. 506
References (Section 4)	p. 507
Appendix
Training NICU nurses and paramedics in the neonatal emergency transport service (NETS)	p. 509
Training delivery room staff in the resuscitation of newborn infants	p. 511
Web links: societies, hospitals, guidelines and learning programs	p. 513
Growth charts	p. 515
Bilirubin diagrams and transfusion exchange limits	p. 516
Aortic blood pressure during the first 12h of life in infants with birth weight 610-4220g	p. 517
Laboratory: normal values	p. 518
Unit conversions	p. 525
References (Section 5)	p. 526
Index	p. 527
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