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Basic Neonatology course
A Road Map
By: Karim El-ghanam
k.elghanam@med.menofia.edu.eg
01068950053
ILOS
1. Why !
2. Job Description.
3. How to deal with your team.
4. Component of NICU
5. Road map for most common cases.
6. What do you need to learn to be qualified.
7. History taking.
Money :D :D
Doctors are not poor !
«ْ‫ن‬ِ‫م‬َ‫ل‬َ‫ع‬ ‫ا‬َ‫ن‬ْ‫ب‬َ‫ت‬َ‫ك‬ َ‫ك‬ِ‫ل‬ََٰ‫ذ‬ ِ‫ل‬ْ‫ج‬َ‫أ‬َ‫أ‬ َ‫ل‬‫ي‬ِ‫ئ‬‫ا‬َ‫ر‬ْ‫س‬ِ‫إ‬ ‫ي‬ِ‫ن‬َ‫ب‬ َٰ‫ى‬‫ن‬َ‫م‬ ُ‫ه‬َّ‫ن‬
َ‫أ‬ ٍ‫س‬ْ‫ف‬َ‫ن‬ ِ‫ر‬ْ‫ي‬َ‫غ‬ِ‫ب‬ ‫ا‬ً‫س‬ْ‫ف‬َ‫ن‬ َ‫ل‬َ‫ت‬َ‫ق‬ِ‫ض‬ْ‫ر‬َ ْ‫اْل‬ ‫ي‬ِ‫ف‬ ٍ‫د‬‫ا‬َ‫س‬َ‫ف‬ ْ‫و‬‫ا‬َ‫م‬َّ‫ن‬َ‫أ‬َ‫ك‬َ‫ف‬
ْ‫ح‬َ‫أ‬ ْ‫ن‬َ‫م‬َ‫و‬ ‫ا‬ً‫ع‬‫ي‬ِ‫م‬َ‫ج‬ َ‫اس‬َّ‫ن‬‫ال‬ َ‫ل‬َ‫ت‬َ‫ق‬َ‫ي‬ْ‫ح‬َ‫أ‬ ‫ا‬َ‫م‬َّ‫ن‬َ‫أ‬َ‫ك‬َ‫ف‬ ‫ا‬َ‫ه‬‫ا‬َ‫ي‬َ‫اس‬َّ‫ن‬‫ال‬ ‫ا‬
‫ا‬ً‫ع‬‫ي‬ِ‫م‬َ‫ج‬«
‫الجـــهل‬!..
‫والتقصــير‬!!..
There is No Precious baby, All Babies are precious .
Job Description
You are a neonatologist resident !
1- Your consultant eyes !
2- Follow the instruction.
3- Emergency situations.
1- Your consultant eyes !
Good, Full detailed description of the cases !
Read More And More
2- Follow the instruction.
3- Emergency situations.
1. Medical Emergencies according to each case:
- Arrest
- Cyanosis
- Convulsion
- Hemorrhage … etc.
2. New cases admission.
•‫الشيتات‬ ‫كتابة‬!
•‫األهل‬ ‫مقابلة‬.
•‫التقارير‬ ‫كتابة‬.
2- Communication with your team
1- Nurses
2- Doctors
3- Consultant
Relatives
Components Of NICU
Incubator
Ventilator CPAP
.1‫األكسجين‬ ‫شبكة‬.
.2‫المخارج‬.
.3Suction!
Most Common Cases
I. Respiratory distress.
II. Neonatal Jaundice.
III.Neonatal Sepsis
IV.Pre-term.
V. Hemorrhagic diseases.
VI.CNS problems.
VII.Pre and post -operative cases.
VIII. .. Etc.
• Grades?
• X.Ray?
• TTT?
• Ventilator Setting?
RDS
• How to diagnose?
• TTT?TTN
• Vigorous or not?
• Resuscitation.
• Discharge or not?
• Ventilator setting?
Meconium
Aspiration
• Grades?
• X.ray?
• TTT?
Congenital
Pneumonia
1- Respiratory Distress (RD)
‫أكسجين‬ ‫:حالة‬D
- Pulmonary Hypertension
- Pneumothorax
1.Downs’ score
2.Oxygen toxicity
3.Chronic lung ( Bronco-pulmonary dysplasia )
2- Neonatal Jaundice (NJ)
I. DD?
II. Specific cause?
III.General condition?
IV.Levels of TTT?
V.Pathophysiology?
3- Neonatal Convulsions.
4- Hemorrhagic disease of the newborn.
5- Necrotizing enterocolitis (NEC)
Neonatal Sepsis
Early signs of Sepsis
ABs Regimen
Infection control
 CRP
Complementary Topics
Fluid Balance.
Drugs.
Feeding.
Normal values of:
- Blood pressure
- Blood sugar
- Temperature
 Infection control.
Complementary Topics
Interpretation of CBC
Interpretation of ABG
Reading X-Ray
Procedures
1.Endotracheal tube (ET).
2.Chest butterfly.
3.Chest cannula.
4.Umbilical catheter.
5.Chest tube.
6.Blood Exchange.
History taking
1.Name: Mother name
‫مدام‬ ‫ابن‬...:
‫مدام‬ ‫بنت‬... :
Medico-legal !
2.Sex:
Male, Female or ambiguous genitalia!
Medico-legal !
3. Sibling:
- History of other siblings.
- IUFD
- Abortions
- RH,ABO incompatibility
- Metabolic, genetic diseases
- Precious baby or not?
- Similar condition
- Mother experience !
G…… P….. + ….
4. Consanguinity :
- For congenital abnormalities.
- Degree of consanguinity.
5. Mode of delivery? NVD or CS
6. Full term, NT or preterm.
- Calculation of the gestational age.
- ‫الـ‬ ‫الشهر‬ ‫لنهاية‬ ‫وصلت‬ ‫اللي‬8‫يبقي‬ ‫كده‬36‫كاملين‬ ‫أسبوع‬!
- Ballard Maturational Assessment
7. Age of the Baby:
DOB: ‫امتي‬ ‫مولود‬
TOB: ‫؟‬ ‫كام‬ ‫الساعة‬
Jaundice
8. Maternal risk factors: ..
9. Parent history:
- Name:
- Age:
- Blood group:
5. Mode of delivery? NVD or CS
NVDCS
• Obstructed labor
• Traumatic Labor
• Less liable for RD
• Cause ?
• Anesthesia
• More Liable for RDS
1- Maternal age:
less than 18 years or more than 35 years old
2- Socio-demographic factors:
• Low educational status
• Cigarette smoking
• Drug addiction
• Poor nutrition
• Poverty
3- Obstetric factors:
• Previous cesarean section
• Multiple pregnancies
• Prior infertility
• Blood transfusion
8. Maternal risk factors:
4- Medical conditions:
• Diabetes mellitus
• Hypertension
• Pregnancy induced hypertension (PIH)
• Pre-eclamsia
• Congenital heart disease
• Auto-immune diseases
• Infections
8. Maternal risk factors:
Referral Reports
Thanks
Hope Happiness finds you every
where !

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