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Medication Adrenaline(Epinephrine) Resuscitation and severe Bradycardia 0.1-0.3 ml/kg, 0.01–0.03 mg/kg(10 to 30 mcg/kg 1:10,000 IV push ETT 0.05-0.1mg/kg followed by 1ml NS IV cont Infusion 0.1 mcg/kg/min adjust to desired response to max 1 mcg/kg/min Monitor HR BP RBS continuously observe IV site for sign of infiltrates ——————————————- SODIUM BICARBONATE: In case of prolonged cardiacContinue reading “Paediatric Emergency Medication”

 ROP. Premature ROP : < 1.5 kg or 32 weeks , who were on oxygen prolong ventilation ROP screening :4 wks or 32 wks. USG cranium :day 1, 7 , 28 days Hearing test : 4 to 6 week of age Indication for hearing test: Had exchange transfusion Whose SBR was near exchange MeningitisContinue reading “ROP Screening in Newborn”

Ventilator parameter > PIP 》 > pao2, < paco2 >PEEP 》>pao2, >paco2 > rate 》<paco2 >Fio2 》 >pao2 >T¡ 》 >pao2 , > paco2 1} hypoxia & hypercapnia 》 > PIP 2} hypoxia with normal paco2 》 >Fio2 Then > T¡ or > RR or > PEEP(not>6) without > PIP 3} hpercarbia with normoxemia >RRContinue reading

ApneaAll infants less then 32 weeksAminophyllin 5mg/kg as loading dose 5m/kg over 10 min then 2 mg/kg/dose every 8-12 hrly followed by oral 5mg /kg/day Q8H. Pt on Aminophyllin w/f irritability,seizure or gastric bleed,tachycardia,feed intolerance, jitteriness,and hyperglycaimiaCaffeine 10mg/kg laoading dose followed by 2.5mg/kg once a day maintence dose

HIE Maintain the bl gases and acid base status in the physiological ranges and prevent hypoxia hyperoxia hypercapnia & hypocapnia. They are at risk of pulmonary HTN Maintain mean BP > 35-40 mm If promptly treat hypotension Dopamine and dobutamine can be used to achieve adequate cardiac output Avoid iatrogenic hypertensive episode Avoid hypo andContinue reading “Treatment Of HIE in NB”

Polycythemia(Hct more the 65%) SGA,Placental Insuffiency,Pre-eclampsia,maternal diabetes,post –term,IDM,CHD,Twin to Twin and Mother to fetus Symtoms and signs: irritable lethargy,poor feeding,hypotonia Complication: Hypogycemia,hypocalcemia, Hyperbilirubinemia, thrombocytopenia, respiratory distress, renal vein thrombosis , renal failure, NEC, seizures Volume for partial exchange=wt in kg*80*(observed-desired Hct)/observed Hct Simple rule is 20 ml/kg

Collodion baby Yellow shiny thigh film covering skin W/f hypothermia dehydration hypernatraemia cutaneous infection poor sucking Inc fluid upto 250ml/kg/day nurse I. High humidity upto 1 hrly application of wihite soft paraffin and liquid paraffin 50:50

Low birth weight 28 wks 1000 gm 30 wks. 1200 gm (28 + 200) 32 wks. 1500 gm (30 + 300) 34 wks. 1900 gm (32 + 400) 36 wks. 2400 gm (34 + 500) LBW. < 2500 VLBW < 1500 ELBW. < 1000 EPT. <26 weekw

Post operative Management 1)Myelomeningocele Sterile management Thermoregulation/Thermoneutral environment Prevent hypothermia Careful hand hygiene Keep stool off the wound/frequent diaper change Nurses prone or at least side lying Avoid pressure on suture line Cardio respiratory monitoring Close monitoring of apnea,hypoxia, HR,BP, W/F raised ICP Record daily head size F/U UGS cranium F/u neonatal hearing evaluation PainContinue reading “Post operative Management in Newborn”

Infant Of Diabetic Mother Glucose monitoring 0 1 2 4 8 12 24 36 & 48 hrs Calcium should be checked at 4&24h HCT @ 4 & 24 hrs SBR @ 24 hrs Breast feeding should be encouraged as early as possible