This document provides information on combat toxicology and chemical weapons. It discusses the history and threats of chemical warfare, as well as the properties, modes of action, signs and symptoms, and treatments for various classes of chemical agents including nerve agents, vesicants, choking agents, and cyanogen agents. Specific agents discussed include tabun, sarin, soman, mustard gas, phosgene, and cyanogen chloride. The document emphasizes the importance of supportive care and describes treatments such as atropine, pralidoxime, and ventilation for chemical agent exposure.
This document provides an overview of meconium aspiration syndrome (MAS) presented by CN third year students at BPKIHS in 2011. It defines MAS as a condition where neonates born through meconium stained amniotic fluid aspirate meconium into their lungs, causing respiratory distress. The presentation covers the incidence, risk factors, pathophysiology, clinical features, diagnostic evaluation, treatment, nursing management, prevention, prognosis and complications of MAS.
Meconium aspiration syndrome (MAS) occurs when an infant aspirates meconium during delivery or birth, leading to respiratory distress. Risk factors include post-term pregnancy or conditions that cause fetal stress. Affected infants experience respiratory distress, often requiring oxygen therapy, CPAP, or mechanical ventilation. Complications can include air leaks, pulmonary hypertension, or long-term lung issues. Treatment focuses on clearing meconium from the airways, managing respiratory support and oxygen needs, and treating complications like infections or pulmonary hypertension. Prevention strategies center on monitoring high risk pregnancies and potentially inducing labor or performing C-sections before complications arise.
This document discusses meconium aspiration syndrome (MAS), a condition where meconium is inhaled or aspirated by an infant before, during, or immediately after birth, causing respiratory distress. MAS occurs when an infant inhales meconium that has been passed in the amniotic fluid due to fetal distress. It presents with respiratory distress within the first hour of life. Diagnosis involves chest x-ray findings and blood gas analysis. Management includes supportive care, suctioning meconium from the airways, oxygen supplementation, and mechanical ventilation as needed. Prevention focuses on suctioning meconium from the nasopharynx after birth to reduce the risk of aspiration into the lungs.
Meconium aspiration syndrome (MAS) is a respiratory distress in infants born through meconium stained amniotic fluid. It occurs in 5% of infants delivered through meconium stained fluid and is caused by mechanical obstruction and chemical pneumonitis from inhaled meconium. Clinical features include respiratory distress, cyanosis, and chest retractions. Diagnosis is confirmed by chest x-ray showing infiltrates and management involves ventilatory support, surfactant therapy, inhaled nitric oxide, and potentially extracorporeal membrane oxygenation. With aggressive treatment, mortality from MAS has decreased to less than 5%.
Meconium aspiration syndrome (MAS) occurs when meconium, the first fecal matter of newborns, is inhaled or aspirated into the lungs around the time of birth. It affects approximately 15 million newborns annually and can lead to respiratory distress and complications. Factors that increase the risk of meconium passage before birth include fetal distress, postmaturity, and maternal health conditions. Diagnosis is based on symptoms of respiratory distress and presence of meconium below the vocal cords. Treatment focuses on supportive care of respiratory symptoms through oxygen therapy, ventilation if needed, and treatment of complications like pulmonary hypertension. Prevention efforts include monitoring high risk mothers and suctioning the mouth and throat of infants immediately
1) Approximately 10% of newborns require some assistance with breathing right after delivery, while 1% require extensive resuscitation. Preparation for high-risk deliveries is key to successful outcomes.
2) The steps of neonatal resuscitation follow the ABCs - clear the airway, initiate breathing, and maintain circulation. Equipment, medications, and guidelines are reviewed to properly perform resuscitation.
3) If meconium is present, the provider should suction the mouth and nose before delivering the shoulders, and may need to intubate and suction if the infant is depressed. Medications like epinephrine may be needed if the heart rate is low after ventilation and chest compressions.
Meconium aspiration syndrome occurs when meconium, the first intestinal discharge of a newborn, is aspirated into the lungs. This can happen when the fetus experiences distress in utero and gasps or takes deep breaths. Meconium aspiration syndrome causes airway obstruction, inflammation, surfactant dysfunction, and can lead to pulmonary hypertension. Treatment involves ventilation support, steroids, antibiotics, surfactant replacement, and potentially ECMO. One study found that administering surfactant to infants under 6 hours old with meconium aspiration syndrome significantly reduced their need for ECMO, time on ventilation, oxygen use, and hospital stay compared to controls.
This document provides information on combat toxicology and chemical weapons. It discusses the history and threats of chemical warfare, as well as the properties, modes of action, signs and symptoms, and treatments for various classes of chemical agents including nerve agents, vesicants, choking agents, and cyanogen agents. Specific agents discussed include tabun, sarin, soman, mustard gas, phosgene, and cyanogen chloride. The document emphasizes the importance of supportive care and describes treatments such as atropine, pralidoxime, and ventilation for chemical agent exposure.
This document provides an overview of meconium aspiration syndrome (MAS) presented by CN third year students at BPKIHS in 2011. It defines MAS as a condition where neonates born through meconium stained amniotic fluid aspirate meconium into their lungs, causing respiratory distress. The presentation covers the incidence, risk factors, pathophysiology, clinical features, diagnostic evaluation, treatment, nursing management, prevention, prognosis and complications of MAS.
Meconium aspiration syndrome (MAS) occurs when an infant aspirates meconium during delivery or birth, leading to respiratory distress. Risk factors include post-term pregnancy or conditions that cause fetal stress. Affected infants experience respiratory distress, often requiring oxygen therapy, CPAP, or mechanical ventilation. Complications can include air leaks, pulmonary hypertension, or long-term lung issues. Treatment focuses on clearing meconium from the airways, managing respiratory support and oxygen needs, and treating complications like infections or pulmonary hypertension. Prevention strategies center on monitoring high risk pregnancies and potentially inducing labor or performing C-sections before complications arise.
This document discusses meconium aspiration syndrome (MAS), a condition where meconium is inhaled or aspirated by an infant before, during, or immediately after birth, causing respiratory distress. MAS occurs when an infant inhales meconium that has been passed in the amniotic fluid due to fetal distress. It presents with respiratory distress within the first hour of life. Diagnosis involves chest x-ray findings and blood gas analysis. Management includes supportive care, suctioning meconium from the airways, oxygen supplementation, and mechanical ventilation as needed. Prevention focuses on suctioning meconium from the nasopharynx after birth to reduce the risk of aspiration into the lungs.
Meconium aspiration syndrome (MAS) is a respiratory distress in infants born through meconium stained amniotic fluid. It occurs in 5% of infants delivered through meconium stained fluid and is caused by mechanical obstruction and chemical pneumonitis from inhaled meconium. Clinical features include respiratory distress, cyanosis, and chest retractions. Diagnosis is confirmed by chest x-ray showing infiltrates and management involves ventilatory support, surfactant therapy, inhaled nitric oxide, and potentially extracorporeal membrane oxygenation. With aggressive treatment, mortality from MAS has decreased to less than 5%.
Meconium aspiration syndrome (MAS) occurs when meconium, the first fecal matter of newborns, is inhaled or aspirated into the lungs around the time of birth. It affects approximately 15 million newborns annually and can lead to respiratory distress and complications. Factors that increase the risk of meconium passage before birth include fetal distress, postmaturity, and maternal health conditions. Diagnosis is based on symptoms of respiratory distress and presence of meconium below the vocal cords. Treatment focuses on supportive care of respiratory symptoms through oxygen therapy, ventilation if needed, and treatment of complications like pulmonary hypertension. Prevention efforts include monitoring high risk mothers and suctioning the mouth and throat of infants immediately
1) Approximately 10% of newborns require some assistance with breathing right after delivery, while 1% require extensive resuscitation. Preparation for high-risk deliveries is key to successful outcomes.
2) The steps of neonatal resuscitation follow the ABCs - clear the airway, initiate breathing, and maintain circulation. Equipment, medications, and guidelines are reviewed to properly perform resuscitation.
3) If meconium is present, the provider should suction the mouth and nose before delivering the shoulders, and may need to intubate and suction if the infant is depressed. Medications like epinephrine may be needed if the heart rate is low after ventilation and chest compressions.
Meconium aspiration syndrome occurs when meconium, the first intestinal discharge of a newborn, is aspirated into the lungs. This can happen when the fetus experiences distress in utero and gasps or takes deep breaths. Meconium aspiration syndrome causes airway obstruction, inflammation, surfactant dysfunction, and can lead to pulmonary hypertension. Treatment involves ventilation support, steroids, antibiotics, surfactant replacement, and potentially ECMO. One study found that administering surfactant to infants under 6 hours old with meconium aspiration syndrome significantly reduced their need for ECMO, time on ventilation, oxygen use, and hospital stay compared to controls.
Meconium aspiration syndrome occurs when meconium, the first intestinal discharge of a newborn, is aspirated into the lungs before, during, or immediately after birth, often due to fetal distress. It can cause airway obstruction, inflammation, edema, and surfactant dysfunction in the lungs. A study found exogenous surfactant administration improved oxygenation and reduced the severity of illness in infants with meconium aspiration syndrome who were treated within 6 hours of birth. The surfactant treatment significantly improved the oxygen index, mean airway pressure, and fraction of inspired oxygen within hours.
New born resuscitation power point presentationMahtab Alam
Bill Keenan was the founder of the Neonatal Resuscitation Program. Birth asphyxia accounts for about 1/4 of the 4 million neonatal deaths worldwide each year. The sequence of neonatal resuscitation is A-B-C, focusing first on airway, then breathing, then circulation. Effective resuscitation requires assessing the newborn, providing warmth, positioning, clearing the airway if needed, drying and stimulating breathing, and providing supplemental oxygen or positive pressure ventilation if needed. Chest compressions and medications may be required if the heart rate does not improve despite ventilation efforts.
Meconium aspiration syndrome (MAS) occurs when meconium, the first stool of infants, is aspirated into the lungs around the time of delivery. Risk factors include post-term pregnancy and fetal distress. MAS can cause respiratory distress through airway obstruction, chemical pneumonitis, surfactant dysfunction, and persistent pulmonary hypertension of the newborn. Treatment involves supportive care like ventilation and surfactant therapy. Adjunctive treatments like inhaled nitric oxide and extracorporeal membrane oxygenation may be used for severe cases. With aggressive management, mortality from MAS has reduced to less than 5%.
Meconium aspiration syndrome occurs when an infant breathes meconium (fecal matter produced before birth) into their lungs before or during delivery, often due to physiological stress in utero. This can lead to lung injury and respiratory distress through mechanisms like airway obstruction, surfactant inactivation, and chemical pneumonitis. Affected infants may experience symptoms like tachypnea, cyanosis, and retractions. Treatment involves vigorous suctioning at birth and supportive care like ventilation and antibiotics. Complications can include pulmonary issues, cardiac problems, and sepsis.
Meconium aspiration syndrome occurs when an infant inhales meconium during delivery or the first breath. Meconium passes into the amniotic fluid when the fetus experiences distress or lack of oxygen in the womb. After birth, the thick meconium can be aspirated into the lungs, causing airway obstruction and respiratory distress like fast breathing, grunting, and cyanosis within a few hours. The aspiration leads to overexpansion and rupture of alveoli as well as collapsed lung areas.
Austin Pediatrics is an open access, peer reviewed, scholarly journal committed to publish articles in all areas of science and practice of Pediatrics.
The aspire of the journal is to present a platform for scientists and academicians all over the world to encourage, distribute, and discuss various new issues and developments in different areas of Pediatrics and to promote responsible and balanced debate on controversial issues that influence child health, including non-clinical areas such as ethics, law, surroundings and economics.
Austin Pediatrics accepts innovative research articles, review articles, case reports and rapid communication on all the aspects of Pediatrics.
Austin Pediatrics is an open access, peer reviewed, scholarly journal committed to publish articles in all areas of science and practice of Pediatrics.
Meconium stained amniotic fluid can occur in 10-25% of births after 34 weeks and may lead to meconium aspiration syndrome (MAS) in 4-10% of cases. MAS causes respiratory distress due to meconium being inhaled into the lungs and can lead to complications like pulmonary hypertension. Risk factors include placental insufficiency, maternal diabetes/hypertension, and post-term delivery. Diagnosis is based on clinical features and chest x-ray findings, and management involves respiratory support, antibiotics, and treatments for pulmonary hypertension. While most cases resolve, severe MAS can cause long-term pulmonary or neurological issues.
Meconium stained amniotic fluid with meconium aspiration syndrome by umasurya720
The document presents a case study of a 1-day-old male infant admitted to the NICU with meconium stained amniotic fluid and meconium aspiration syndrome. The infant showed signs of respiratory distress, jaundice, and bilateral lung crackles. Tests confirmed low blood oxygen and patchy lung infiltrates. The treatment plan included antibiotics, oxygen therapy, IV fluids and monitoring the infant's respiratory status and oxygen saturation daily. Over five days the infant showed improved respiratory distress and stable vital signs.
This document discusses the evaluation and management of fever without source in infants and children. It defines fever without source and outlines the differential diagnosis. Key points include:
- Fever accounts for 20-35% of pediatric visits and 5-20% will have no apparent source after examination.
- Fever is regulated by the hypothalamus and results from pyrogens stimulating an increased set point.
- For infants under 3 months, a full sepsis workup is considered. Criteria like Rochester can help determine low risk for outpatient management.
- For children 3-36 months, the Yale Observation Scale can identify toxic-appearing children needing admission versus low-risk children who can be treated as out
An approach to a child with abnormal movementSunil Agrawal
This document provides an overview of approaches to evaluating and diagnosing abnormal movements in children. It discusses the pathophysiology, classification, history taking, physical examination, investigations, and management of various movement disorders. The key components involved in movement are the basal ganglia and frontal cortex. Movement disorders are classified based on the type of abnormal movement and their underlying cause. A thorough history and physical exam aim to characterize the pattern, timing, exacerbating/relieving factors of the movements. Investigations include blood tests, imaging, and electrophysiological studies to identify underlying neurological or systemic conditions. Treatment involves addressing the specific cause, symptomatic relief of movements, and counseling.
This document discusses meconium passage and meconium aspiration syndrome. It describes the composition and consistency of meconium and risk factors for meconium passage. Meconium aspiration syndrome occurs when meconium is inhaled or aspirated and leads to respiratory distress in infants. The document outlines strategies for preventing and managing meconium aspiration, including antenatal, intrapartum and postnatal interventions. However, evidence for many practices is conflicting and some interventions like saline lavage are potentially harmful. Vigorous infants with meconium-stained amniotic fluid generally do not require airway suctioning.
Shoulder dystocia occurs when the baby's shoulders become stuck after delivery of the head. It has a low incidence rate of 0.2-1% and risk factors include fetal macrosomia, obesity, diabetes and others. Diagnosis is made when normal maneuvers by the midwife fail to deliver the baby. Management involves calling for help, clearing the baby's airways, and performing maneuvers like McRoberts and Rubin's to rotate the shoulders and decrease their diameter in order to allow delivery. More invasive maneuvers like cleidotomy may be needed if these fail to deliver the anterior shoulder.
The document summarizes changes to the 7th edition of NRP guidelines. Key changes include: delayed cord clamping is recommended for 30-60 seconds for term and preterm infants without need for resuscitation; meconium-stained amniotic fluid no longer requires routine intubation; assessment order changed to gestation, tone, breathing; PPV indications clarified; oxygen administration guidelines updated; chest compressions ratio changed to 90:30. Highest priorities are effective ventilation and establishing an artificial airway if needed before starting compressions.
Meconium aspiration syndrome is a respiratory condition in newborns who pass meconium in the amniotic fluid before delivery. It occurs when meconium is aspirated or inhaled into the lungs around birth. Risk factors include post-term pregnancy or maternal health conditions. Clinically, affected infants have respiratory distress. Management involves suctioning meconium from the airways, providing respiratory support, antibiotics, and other organ system support. Outcomes range from full recovery to complications like chronic lung disease.
This document provides an overview of a lecture on neonatal resuscitation guidelines. It discusses:
1) The importance of being prepared for resuscitation with properly trained staff and functioning equipment available.
2) Factors that increase risk for needing resuscitation include prematurity, maternal medical conditions, and meconium in the amniotic fluid.
3) Key steps in resuscitation including maintaining temperature, assessing heart rate, clearing the airway, and providing oxygen while avoiding unnecessary interventions.
4) Updates to cord clamping recommendations and the potential role of ECG to rapidly assess heart rate.
The document discusses developmental assessment in children, including principles of development, domains of development to assess, screening and diagnostic tests used, developmental milestones, and red flags indicating the need for further evaluation. Development progresses in a predictable sequence but at variable rates, and standardized tools can screen for or further assess delays and abnormalities in motor, language, social, and other skills.
This document discusses techniques for oxygen delivery in pediatric patients. It describes various low and high flow oxygen delivery systems including masks, nasal cannulas, tents, and endotracheal tubes. Low flow systems like simple masks can deliver 35-60% oxygen while high flow systems like non-rebreathing masks or endotracheal tubes can provide over 90% oxygen concentration. Adjuncts like oropharyngeal and nasopharyngeal airways are also reviewed. The appropriate device is chosen based on the patient's condition and oxygen needs. Proper sizing and technique are emphasized for effective oxygen delivery.
This document contains an OSCE (Objective Structured Clinical Examination) practice exam for pediatrics. It includes 10 multiple choice matching questions that pair drugs used in pregnancy with their expected adverse effects on the fetus. It also includes several short clinical vignettes followed by 5 questions each. The vignettes cover topics like interpreting an ABG result, identifying sickle cell anemia from a peripheral smear, making a diagnosis of retropharyngeal abscess from presented symptoms, and more. The goal of the summary is to provide a high-level overview of the content and focus of the practice exam.
This document describes the case of a 46-year-old male with no prior medical history who presented with chest pain and was found to have an ST elevation myocardial infarction (STEMI). He underwent treatment including thrombolysis and stenting, with resolution of symptoms. Two days later, he tested positive for COVID-19. Despite being asymptomatic, his D-dimer level rose significantly, indicating a COVID-19 associated coagulopathy. He was discharged on rivaroxaban for 3 weeks to prevent thrombosis given his elevated risk. The document then reviews the coagulopathy seen in COVID-19 patients and guidelines for extended thromboprophylaxis on discharge for high-risk medical patients.
This document discusses LAMP (loop-mediated isothermal amplification), a diagnostic technique for visual virus detection. LAMP offers advantages over PCR like higher sensitivity, specificity, speed, and simplicity. It can detect as little as 10 femtograms of DNA under isothermal conditions in 60 minutes. The document reviews the ideal properties of diagnostic tests, different isothermal amplification techniques, LAMP primers and enzymes, result interpretation methods, LAMP stability and applications for detecting various animal viruses. While sensitive, LAMP is prone to product cross-contamination; solutions to address this like closed-tube reactions and pre-made mixtures are proposed to make LAMP suitable for field-level pathogen diagnosis.
Meconium aspiration syndrome occurs when meconium, the first intestinal discharge of a newborn, is aspirated into the lungs before, during, or immediately after birth, often due to fetal distress. It can cause airway obstruction, inflammation, edema, and surfactant dysfunction in the lungs. A study found exogenous surfactant administration improved oxygenation and reduced the severity of illness in infants with meconium aspiration syndrome who were treated within 6 hours of birth. The surfactant treatment significantly improved the oxygen index, mean airway pressure, and fraction of inspired oxygen within hours.
New born resuscitation power point presentationMahtab Alam
Bill Keenan was the founder of the Neonatal Resuscitation Program. Birth asphyxia accounts for about 1/4 of the 4 million neonatal deaths worldwide each year. The sequence of neonatal resuscitation is A-B-C, focusing first on airway, then breathing, then circulation. Effective resuscitation requires assessing the newborn, providing warmth, positioning, clearing the airway if needed, drying and stimulating breathing, and providing supplemental oxygen or positive pressure ventilation if needed. Chest compressions and medications may be required if the heart rate does not improve despite ventilation efforts.
Meconium aspiration syndrome (MAS) occurs when meconium, the first stool of infants, is aspirated into the lungs around the time of delivery. Risk factors include post-term pregnancy and fetal distress. MAS can cause respiratory distress through airway obstruction, chemical pneumonitis, surfactant dysfunction, and persistent pulmonary hypertension of the newborn. Treatment involves supportive care like ventilation and surfactant therapy. Adjunctive treatments like inhaled nitric oxide and extracorporeal membrane oxygenation may be used for severe cases. With aggressive management, mortality from MAS has reduced to less than 5%.
Meconium aspiration syndrome occurs when an infant breathes meconium (fecal matter produced before birth) into their lungs before or during delivery, often due to physiological stress in utero. This can lead to lung injury and respiratory distress through mechanisms like airway obstruction, surfactant inactivation, and chemical pneumonitis. Affected infants may experience symptoms like tachypnea, cyanosis, and retractions. Treatment involves vigorous suctioning at birth and supportive care like ventilation and antibiotics. Complications can include pulmonary issues, cardiac problems, and sepsis.
Meconium aspiration syndrome occurs when an infant inhales meconium during delivery or the first breath. Meconium passes into the amniotic fluid when the fetus experiences distress or lack of oxygen in the womb. After birth, the thick meconium can be aspirated into the lungs, causing airway obstruction and respiratory distress like fast breathing, grunting, and cyanosis within a few hours. The aspiration leads to overexpansion and rupture of alveoli as well as collapsed lung areas.
Austin Pediatrics is an open access, peer reviewed, scholarly journal committed to publish articles in all areas of science and practice of Pediatrics.
The aspire of the journal is to present a platform for scientists and academicians all over the world to encourage, distribute, and discuss various new issues and developments in different areas of Pediatrics and to promote responsible and balanced debate on controversial issues that influence child health, including non-clinical areas such as ethics, law, surroundings and economics.
Austin Pediatrics accepts innovative research articles, review articles, case reports and rapid communication on all the aspects of Pediatrics.
Austin Pediatrics is an open access, peer reviewed, scholarly journal committed to publish articles in all areas of science and practice of Pediatrics.
Meconium stained amniotic fluid can occur in 10-25% of births after 34 weeks and may lead to meconium aspiration syndrome (MAS) in 4-10% of cases. MAS causes respiratory distress due to meconium being inhaled into the lungs and can lead to complications like pulmonary hypertension. Risk factors include placental insufficiency, maternal diabetes/hypertension, and post-term delivery. Diagnosis is based on clinical features and chest x-ray findings, and management involves respiratory support, antibiotics, and treatments for pulmonary hypertension. While most cases resolve, severe MAS can cause long-term pulmonary or neurological issues.
Meconium stained amniotic fluid with meconium aspiration syndrome by umasurya720
The document presents a case study of a 1-day-old male infant admitted to the NICU with meconium stained amniotic fluid and meconium aspiration syndrome. The infant showed signs of respiratory distress, jaundice, and bilateral lung crackles. Tests confirmed low blood oxygen and patchy lung infiltrates. The treatment plan included antibiotics, oxygen therapy, IV fluids and monitoring the infant's respiratory status and oxygen saturation daily. Over five days the infant showed improved respiratory distress and stable vital signs.
This document discusses the evaluation and management of fever without source in infants and children. It defines fever without source and outlines the differential diagnosis. Key points include:
- Fever accounts for 20-35% of pediatric visits and 5-20% will have no apparent source after examination.
- Fever is regulated by the hypothalamus and results from pyrogens stimulating an increased set point.
- For infants under 3 months, a full sepsis workup is considered. Criteria like Rochester can help determine low risk for outpatient management.
- For children 3-36 months, the Yale Observation Scale can identify toxic-appearing children needing admission versus low-risk children who can be treated as out
An approach to a child with abnormal movementSunil Agrawal
This document provides an overview of approaches to evaluating and diagnosing abnormal movements in children. It discusses the pathophysiology, classification, history taking, physical examination, investigations, and management of various movement disorders. The key components involved in movement are the basal ganglia and frontal cortex. Movement disorders are classified based on the type of abnormal movement and their underlying cause. A thorough history and physical exam aim to characterize the pattern, timing, exacerbating/relieving factors of the movements. Investigations include blood tests, imaging, and electrophysiological studies to identify underlying neurological or systemic conditions. Treatment involves addressing the specific cause, symptomatic relief of movements, and counseling.
This document discusses meconium passage and meconium aspiration syndrome. It describes the composition and consistency of meconium and risk factors for meconium passage. Meconium aspiration syndrome occurs when meconium is inhaled or aspirated and leads to respiratory distress in infants. The document outlines strategies for preventing and managing meconium aspiration, including antenatal, intrapartum and postnatal interventions. However, evidence for many practices is conflicting and some interventions like saline lavage are potentially harmful. Vigorous infants with meconium-stained amniotic fluid generally do not require airway suctioning.
Shoulder dystocia occurs when the baby's shoulders become stuck after delivery of the head. It has a low incidence rate of 0.2-1% and risk factors include fetal macrosomia, obesity, diabetes and others. Diagnosis is made when normal maneuvers by the midwife fail to deliver the baby. Management involves calling for help, clearing the baby's airways, and performing maneuvers like McRoberts and Rubin's to rotate the shoulders and decrease their diameter in order to allow delivery. More invasive maneuvers like cleidotomy may be needed if these fail to deliver the anterior shoulder.
The document summarizes changes to the 7th edition of NRP guidelines. Key changes include: delayed cord clamping is recommended for 30-60 seconds for term and preterm infants without need for resuscitation; meconium-stained amniotic fluid no longer requires routine intubation; assessment order changed to gestation, tone, breathing; PPV indications clarified; oxygen administration guidelines updated; chest compressions ratio changed to 90:30. Highest priorities are effective ventilation and establishing an artificial airway if needed before starting compressions.
Meconium aspiration syndrome is a respiratory condition in newborns who pass meconium in the amniotic fluid before delivery. It occurs when meconium is aspirated or inhaled into the lungs around birth. Risk factors include post-term pregnancy or maternal health conditions. Clinically, affected infants have respiratory distress. Management involves suctioning meconium from the airways, providing respiratory support, antibiotics, and other organ system support. Outcomes range from full recovery to complications like chronic lung disease.
This document provides an overview of a lecture on neonatal resuscitation guidelines. It discusses:
1) The importance of being prepared for resuscitation with properly trained staff and functioning equipment available.
2) Factors that increase risk for needing resuscitation include prematurity, maternal medical conditions, and meconium in the amniotic fluid.
3) Key steps in resuscitation including maintaining temperature, assessing heart rate, clearing the airway, and providing oxygen while avoiding unnecessary interventions.
4) Updates to cord clamping recommendations and the potential role of ECG to rapidly assess heart rate.
The document discusses developmental assessment in children, including principles of development, domains of development to assess, screening and diagnostic tests used, developmental milestones, and red flags indicating the need for further evaluation. Development progresses in a predictable sequence but at variable rates, and standardized tools can screen for or further assess delays and abnormalities in motor, language, social, and other skills.
This document discusses techniques for oxygen delivery in pediatric patients. It describes various low and high flow oxygen delivery systems including masks, nasal cannulas, tents, and endotracheal tubes. Low flow systems like simple masks can deliver 35-60% oxygen while high flow systems like non-rebreathing masks or endotracheal tubes can provide over 90% oxygen concentration. Adjuncts like oropharyngeal and nasopharyngeal airways are also reviewed. The appropriate device is chosen based on the patient's condition and oxygen needs. Proper sizing and technique are emphasized for effective oxygen delivery.
This document contains an OSCE (Objective Structured Clinical Examination) practice exam for pediatrics. It includes 10 multiple choice matching questions that pair drugs used in pregnancy with their expected adverse effects on the fetus. It also includes several short clinical vignettes followed by 5 questions each. The vignettes cover topics like interpreting an ABG result, identifying sickle cell anemia from a peripheral smear, making a diagnosis of retropharyngeal abscess from presented symptoms, and more. The goal of the summary is to provide a high-level overview of the content and focus of the practice exam.
This document describes the case of a 46-year-old male with no prior medical history who presented with chest pain and was found to have an ST elevation myocardial infarction (STEMI). He underwent treatment including thrombolysis and stenting, with resolution of symptoms. Two days later, he tested positive for COVID-19. Despite being asymptomatic, his D-dimer level rose significantly, indicating a COVID-19 associated coagulopathy. He was discharged on rivaroxaban for 3 weeks to prevent thrombosis given his elevated risk. The document then reviews the coagulopathy seen in COVID-19 patients and guidelines for extended thromboprophylaxis on discharge for high-risk medical patients.
This document discusses LAMP (loop-mediated isothermal amplification), a diagnostic technique for visual virus detection. LAMP offers advantages over PCR like higher sensitivity, specificity, speed, and simplicity. It can detect as little as 10 femtograms of DNA under isothermal conditions in 60 minutes. The document reviews the ideal properties of diagnostic tests, different isothermal amplification techniques, LAMP primers and enzymes, result interpretation methods, LAMP stability and applications for detecting various animal viruses. While sensitive, LAMP is prone to product cross-contamination; solutions to address this like closed-tube reactions and pre-made mixtures are proposed to make LAMP suitable for field-level pathogen diagnosis.
Central Neuroxial blockage ( Spinal and Epidural block ) By Dr Sachin GaikwadSachin Gaikwad
This document discusses the anatomy and techniques related to central neuroaxial blockade. It covers the anatomy of the vertebral column, spinal cord, meninges, epidural space and its contents. It describes the physiological effects of spinal and epidural anesthesia. Some key points include:
- Spinal anesthesia involves injection of local anesthetic into the subarachnoid space
- Factors like drug used, volume, patient position can affect the level and duration of the block
- Potential complications include hypotension, nausea, urinary retention
- Epidural anesthesia is commonly used for postoperative pain control and labor pain.
- 34 year old male from Pakistan presents with fever, rigors, and sweats for 3 days after travel to Croatia 14 days prior. Physical exam is notable for fever of 102.7F but otherwise unremarkable.
- Malaria is endemic in parts of Pakistan, transmitted by several mosquito species. P. falciparum is increasing and causes the most severe disease.
- The patient likely has malaria acquired in Pakistan or Croatia, with P. falciparum or P. vivax being the most common causes. He will be treated with intravenous quinidine followed by oral therapy if parasites decrease sufficiently.
Fungal infections are an important cause of morbidity and mortality in ICU patients. The document discusses epidemiology of fungal infections in Indian ICUs and compares it to other countries. It provides guidelines on diagnosis of invasive fungal infections using tests like blood cultures, beta-D-glucan, galactomannan etc. Treatment options for various fungal infections including candidiasis, aspergillosis and mucormycosis are discussed along with dosing and side effects of antifungal drugs like amphotericin B, fluconazole, voriconazole, echinocandins etc. Management of specific conditions like intra-abdominal candidiasis and use of antifungal
Nuclear medicine radiology revision notesTONY SCARIA
Nuclear medicine uses radiopharmaceuticals and imaging techniques like PET and SPECT scans to assess organ function and detect diseases. Some key applications include using F-18 FDG PET scans to identify cancer metastases based on increased glucose metabolism in malignant cells, Tc-99m sestamibi scans to detect myocardial ischemia, Tc-99m DMSA renal scans to assess kidney function, and somatostatin receptor imaging with radiolabeled octreotide to localize neuroendocrine tumors. PET provides superior detection of bone metastases compared to bone scans or whole-body MRI. Important considerations for nuclear medicine exams include selecting the appropriate radiotracer and ensuring normal blood glucose levels for oncology FDG PET scans
a case study on burn injury / case presentation on burn injury martinshaji
Damage to the skin or deeper tissues caused by sun, hot liquids, fire, electricity or chemicals.
The degree of severity of most burns is based on the size and depth of the burn. Electrical burns, however, are more difficult to diagnose because they're capable of causing significant injury beneath the skin without showing any signs of damage on the surface.
Symptoms range from a feeling of minor discomfort to a life-threatening emergency, depending on the size and depth (degree) of the burn.
Sunburn and small scalds can often be treated at home. Deep or widespread burns and chemical or electrical burns need immediate medical care, often at specialised burn units.
A burn is a type of injury to skin, or other tissues, caused by heat, cold, electricity, chemicals, friction, or radiation (like sunburn). Most burns are due to heat from hot liquids (called scalding), solids, or fire. While rates are similar for males and females the underlying causes often differ.
this is a case study on burn injury , this details about the diagnosis, management, treatment, patient counselling & pharmacist interventions , regarding medication etc , and also describes in detail about all aspects of burn injury .
please comment
thank u
A patient was admitted with a 2-week history of fever. Tests revealed a 6mm vegetation on the aortic valve and blood cultures positive for Staphylococcus aureus, leading to a diagnosis of infective endocarditis. The patient's history included recent aortic valve replacement and a family history of myocardial infection. Treatment involved 4-6 weeks of vancomycin to treat the infection.
All-trans retinoic acid related complications in a patient with acute promy...Choying Chen
1) The patient, a 6-year-old female, presented with generalized petechiae and prolonged epistaxis. Laboratory results showed high white blood cell count with 46% blasts and 44% promyelocytes containing Auer rods, consistent with acute promyelocytic leukemia (APL).
2) She received induction therapy for APL per the TPOG-APL-2001 protocol including all-trans retinoic acid (ATRA) and chemotherapy. She experienced complications including fever, pleural effusion, and later pseudotumor cerebri, thought to be related to a drug-drug interaction between ATRA and fluconazole.
3) Her course
This document describes the case of a 32-year-old female patient admitted with stage IIIB cervical cancer. She presented with white discharge for 3 months, abdominal and pelvic pain, and abnormal bleeding. Biopsy revealed moderately differentiated non-keratinizing large cell squamous cell carcinoma of the cervix. She received 12 cycles of chemotherapy with doxorubicin, cisplatin, and other medications. Her tumor size reduced and symptoms improved over treatment. She was counseled on her disease, treatments, and medication side effects prior to discharge.
This document provides an overview of pheochromocytoma, which are rare catecholamine-producing tumors. Key points include:
- Pheochromocytomas arise from sympathetic nervous system and can be sporadic or inherited. Approximately 25% of cases are associated with genetic syndromes.
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Pediatrics new born resuscitation dr.gangadhar rao g m+91 949 3864 912
1. NEW BORN RESUSCITATION &
MECONIUM ASPIRATION
Dr. G GANGADHAR RAO
GUNTUR MEDICAL COLLEGE
FORMER PAEDIATRICIAN YASHODA HOSPITAL SEC.
Department of Pediatrics
COMPOSITE HOSPITAL CRPF HYDERABAD
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3. MECONIUM ASPIRATION
SYNDROME
Mortality and morbidity is 28% to 40% of MAS.
INCIDENCE IS 8.8%, USUALLY POSTMATURE INFANTS,
APGAR SCORE 1- 5 Min. IS LESS THAN 6
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4. What is Meconium?
• In Greek - means "Poppy juice".
• Black Green, Thick sticky odorless and acidic
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5. Contents
• Water 72%-80% • Proteins
• Intestinal secretions • Lipids 8% dry wt.
• Epithelial cells • Bile acids and salts
• Swallowed Amniotic fluid • Enzymes
• Mucopolysacchrides 80% • Blood substances
of dry wt. • Squamous cells and
• Cholesterol and Sterol Vernix caseosa.
precursors
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7. Pathogenesis
• Bile salts are blamed for. Exact cause unknown.
• Inflammatory response by lung tissue.
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8. Introduction
• Cause of Respiratory failure in newborn.
• Inhalation of Meconium causes respiratory distress.
• Degree of severity vary.
• Meconium in Amniotic fluid 10%-20% of total deliveries.
• Mortality and morbidity in 28% to 40%
of MAS.
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9. Incidence
• Amniotic fluid stained in 16.5% (India)
• MAS develop in 18.7%
• MAS 1.44% in all births
• No seasonal variation
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10. Definition
• Meconium below the vocal cords.
• Mild MAS < 40% Oxygen needed for < 48 hrs.
• Moderate MAS > 40% Oxygen needed for > 48 hrs.
• Severe MAS Ventilation > 48 hrs often with
persistent pulmonary hypertension.
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11. Working definition
• Staining of Liquor Umbilical cord. Skin and nail.
• Respiratory distress after 1 hr of birth.
• Radiological features of Aspiration pneumonitis.
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12. Causes in-utero
• Meconium staining rarely
before 38wt
• Levels of motilin
• Maturity of myelination of
• Foetal distress – hypoxia
gut
• Diving reflex
• Lack of strong peristalsis
of gut • Umbilical cord
compression
• Good sphincter tone
• Gut maturation
• „Cap‟ viscous meconium in
rectum • Breech presentation
• Listeriosis in foetus –
foetal diarrhoea
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13. Risk factor
• Maternal hypertension and diabetes mellitus
• Maternal heavy smoking.
• Chronic Respiratory and CVS disease.
• Post term pregnancy.
• Pre eclampsia / Eclampsia.
• Oligohydramnios.
• Poor biophysical profile.
• Foetal distress (Abnormal
Heart Rate)
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14. Mechanism of injury
1. Mechanical Obstruction.
2. Pneumothorax – “Ball Valve”.
3. Pneumonitis
1. Bile salts
2. Bile acids
3. Release of cytokines
4. Pulmonary Vasoconstriction.
5. Surfactant Inactivation.
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16. Clinical Features
• Usually full term and post term
• Signs of post maturity.
• Green Yellow staining of nails, skin and umbilical cord.
• Afebrile, Fever or hypothermia if infected.
• Resp. rate > 120/min.
• Subcostal, Intercostal and sternal retraction.
• Use of accessory muscles
• Flaring of nostrils
• Grunt
• Increased Ant. Post diameter
• Apnoea
• Rhonchi and crepitations.
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17. Clinical Features - Contd..
CVS 1. Hypoxic myocardial damage.
2. Hypotension
3. CCF
4. S2 may be single
5. Murmur of tricuspid regurgitation
Abd 1. Distended (Aerophagia)
2. Liver and Spleen displaced.
3. Constipation.
4. Absent bowel sounds in severe cases.
5. Urinary retention.
CNS: 1. Hypoxic ischemic Encephalopathy.
2. Signs of birth asphyxia. RAO G
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21. Diagnosis
• Meconium stained amniotic
fluid (MSAF)
• Presence of meconium in trachea.
• Radiological features.
Always suspect MAS in MSAF.
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22. Investigations
• Hb % normal
• White cell count R
• Thrombocytopenia with PPH
• Disseminated Intravascular coagulation
• PaCO2 Low – Normal - Raised
• Metabolic acidemia
• Culture for sepsis
• Parameters of renal failure
• Urine analysis – Normal except in renal failure
• Color is Greenish brown due to Meconium pigment
• ECG -Normal
• ECHO – Reduced cardiac contractility
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24. Radiology
Use: Determine the extent of intrathoracic
pathology
• Identify areas of atelectasis and air block
syndromes.
• Assure appropriate positioning of endotracheal tube
and umbilical artery catheter.
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25. Radiology - Contd..
• Patchy infiltrates.
• Increased anterioposterior diameter.
• Atelectasis.
• Flattening of diaphragm.
• Retrosternal lucency.
• Small pleural effusions in about 33% cases.
• Pneumothorax and/or pneomediastinum in 25% cases.
• Diffuse chemical pneumonitis
• Cardiomegaly to be detected due to underlying perinatal
asphyxia
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29. Prevention
• Optimum Antenatal care
• Risk factors for MAS
• Monitoring of foetal heart for
foetal distress
• Foetal scalp blood pH where possible
• Expediate delivery if foetal distress
• Avoid post maturity (more than 42 wt.)
• Presence of two skilled persons in resuscitation for every
delivery in labour room
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31. Prevention contd.
Intrapartum MSAF present:
• Aspirate oropharynx first then nasopharynx after
the birth of head.
• Assess the newborn after birth.
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32. Classification
Vigorous Newborn: Non Vigorous Newborn:
• Strong spontaneous Resp. Airway suction
Effort Direct laryngoscopy and
• Good muscle tone suction
• Heart rate > 100/min
• Monitor for MAS
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40. NEW BORN RESUSCITATION
Intubate
• Suction through Intubation tube.
• Continue tracheal aspiration with meconium
aspiration till “little or no meconium is aspirated or
heart rate indicates resuscitation”.
• Aspirate Gastric meconium
sev asthma.MP G
Last 4 slides DR.GANGADHAR RAO G 40
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50. Do’s
1. Oropharyngeal suction at perineum in all MSAF babies.
2. Intrapartum fetal heart rate monitoring in all MSAF
babies.
3. Anticipate passage of meconium or MAS during birth of
all IUGR babies in the labor room.
4. Skillful resuscitation and assistance are key points in
management.
5. Do intubate neonates born through MSAF who are
depressed (non vigorous babies) at birth irrespective of
consistency of meconium.
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52. Dont’s
• Do not go by the consistency of
meconium in management for intubation.
• Do not apply cricoid pressure,
chest compression or occlude
airway by fingers to prevent initiation
of respiration in MSAF babies.
• Do not ignore the general condition of baby during
intubation.
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Thank you 52
53. CH CRPF PHOTOES – (SEE FILE)
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64. Thank you
Dr. G GANGADHAR RAO
STUDENT OF GUNTUR MEDICAL COLLEGE
FORMER PAEDIATRICIAN YASHODA HOSPITAL SEC.
Department of Pediatrics
COMPOSITE HOSPITAL CRPF HYDERABAD
DR.GANGADHAR RAO G 64
M09493864912
65. Thank you
Dr. G GANGADHAR RAO
STUDENT OF GUNTUR MEDICAL COLLEGE
FORMER PAEDIATRICIAN YASHODA HOSPITAL SEC.
Department of Pediatrics
COMPOSITE HOSPITAL CRPF HYDERABAD
DR.GANGADHAR RAO G 65
M09493864912