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Danger signs in newborns

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Danger signs in newborns

  1. 1. Danger Signs in NewbornDr Varsha Atul Shah 1
  2. 2. Sick newborn Early detection, prompt treatment and referral (if required)are necessary to prevent high mortality 2
  3. 3. Problems in early diagnosis of sick newborn Non-specific signs Difficulties in preterm and LBW babies 3
  4. 4. Lethargy and poor sucking In a term baby who was feeding earlier → indicates neonatal illness (as perceived by mother) In a preterm baby → needs careful assessment because it may be due to cold stress or immaturity 4
  5. 5. Capillary refill time (CRT) Indicates tissue perfusion Normal CRT < 3 seconds Prolonged CRT > 3 seconds * Use 10ml/kg normal saline bolus* Hypotension, hypothermia, acidosis 5
  6. 6. Capillary refill time (CRT) 6
  7. 7. Respiratory problems RR > 60 / min* Retractions Grunt Central cyanosis Apnea *Rate should be counted in a quiet state and not immediately after feed 7
  8. 8. RETRACTIONS 8
  9. 9. Body temperature in newborn infant ( C) o 37.5oNormal range 36.5oCold stress Cause for concern 36.0oModerate hypothermia Danger, warm baby 32.0oSevere hypothermia Outlook grave, skilled care urgently needed 9
  10. 10. Failure to pass meconium and urineFailure to pass meconiumMajority pass within 24 hrs Delayed passage May have passed in –utero Lubricated per-rectal thermometer may be therapeutic Suspect obstructionFailure to pass urineMajority pass within 48 hrs Delayed passage Exclude obstructive uropathy or renal agenesis 10
  11. 11. Causes of vomiting* Ingestion of meconium stained amniotic fluid Systemic illness Congestive cardiac failure Raised ICP – IVH, asphyxia Metabolic disorders (CAH, galactosemia)*Persistent, projectile or bile stained - r / o intestinal obstruction 11
  12. 12. Causes of diarrhea Infective diarrhea* (often non breast fed baby) Maternal ingestion of drugs (ampicillin, laxatives) Metabolic disorders Thyrotoxicosis Maternal drug addiction*Infective diarrhea needs treatment with systemic antibiotics 12
  13. 13. CyanosisPeripheral Normal at birth Seen in extremities due to coldCentral Always needs appropriate referral Seen on lips and mucosa Indicates cardiac or pulmonary disease 13
  14. 14. Peripheral cyanosis 14
  15. 15. Central cyanosis 15
  16. 16. Yellow Palms & Soles 16
  17. 17. Yellow staining of soles 17
  18. 18. Tracheo-esophageal fistula Excessive drooling; choking; cyanosis during feeds; respiratory distress Failure to pass red rubber catheter beyond 8 to 10 cm from mouth 18
  19. 19. Tracheo-esophageal fistula 19
  20. 20. Suspect cardiac disease Cyanosis Tachycardia Murmur Hepatomegaly Shock Cardiomegaly 20
  21. 21. Abnormal weight loss pattern > 10 percent of birth weight in term > 15 percent in preterm > 5 percent acute weight loss 21
  22. 22. Danger signs : Summary Lethargy  Bleeding Hypothermia  Yellow palms/ Respiratory distress soles Cyanosis  Excessive wt. loss Convulsion  Vomiting Abd. distension  Diarrhea 22

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