Rationale
Neonatal distress is a relatively common occurrence. Failure to identify and appropriately manage an infant in distress in a timely manner can potentially lead to significant morbidity and mortality.
Causal Conditions
(list not exhaustive)
- Prematurity
- Pulmonary (e.g., meconium aspiration, pneumothorax)
- Decreased respiratory drive (e.g., maternal medications, asphyxia)
- Cardiovascular (e.g., anemia, congenital heart disease)
- Infection
Key Objectives
In cases of a neonatal distress, the candidate will be able to assess the need for and initiate resuscitation, identify causal and ongoing pathologies, and determine ongoing needs, including whether the infant requires level 2 or level 3 neonatal intensive care.
Enabling Objectives
In cases of neonatal distress, the candidate will
- list and interpret critical clinical findings, including
- physical signs and symptoms that necessitate immediate resuscitation;
- maternal and perinatal history;
- physical examination findings relevant to formulating a differential diagnosis;
- list and interpret critical initial investigations targeted towards identifying an underlying cause (e.g., cord blood gas, blood glucose);
- construct an effective initial management plan, including
- neonatal resuscitation;
- elements of ongoing supportive care, including;
- thermoregulation;
- fluid and electrolyte balance;
- sepsis management;
- cardiorespiratory support;
- appropriate communication with caregiver(s);
- appropriate consultation or referral.