Fussy Neonate – a Jeopardy game!

Maya S. Iyer, MD, FAAP, Clinical Assistant Professor of Pediatrics, Nationwide Children’s Hospital, Section of Emergency Medicine

Fussy Neonate Jeopardy

This jeopardy game highlights key clinical considerations for infants who present to the emergency department with the chief complaint of fussiness. In particular, the topics highlighted in this game include: fever in the neonate, sudden infant death syndrome (SIDS), brief resolved unexplained events (BRUE) and apparent life threatening events (ALTE), non-accidental trauma (NAT) and a potpourri of other interesting clinical conditions.  The questions require second order thinking. After completing this game, emergency medicine residents should be able to describe the cardinal signs and symptoms, management and possible complications of the above conditions.

 

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Conference Notes cont…

This is part 2 of my review of Dr. Maloney’s lecture on “The Critically Ill Neonate in Your Community ED.”

After introducing the Pediatric Assessment Triangle, Dr. Maloney reviewed some unique considerations with pediatric ABC’s.

Airway

1.  Because of the baby’s big occiput and flexible neck and trachea, use a shoulder roll to help with visualization

2. Babies have a higher, more anterior glottis, so “look up, pull back”

3.  Used cuffed tubes for any pediatric intubation.  This is a change from previous PALS guidelines

Breathing

1.  Disable the “pop-off valve.”  Instead, watch for chest rise and let that guide your bagging

Circulation

1.  IO is the preferred method for access in a sick baby.

2.  The umbilical vein can be used up to 7-10 days.  Use a 20 gauge angiocath or 5 French feeding tube. Continue reading

Conference Notes

First off, welcome back! I think we’ve finally worked the kinks out of this blog thing and I’m all ready to go! One thing I’d like to start doing each week is summarizing some key points we learned from our lecture series each week. To start out, I want to review the AMAZING pediatrics lecture given by Patrick Maloney, MD one of the pediatric emergency medicine fellows. I learned so much from this lecture! The topic was “the critically ill neonate in your community ED.” Here’s some key take-home points:
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