Stabilising neonates

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Start with the basics

  • Airways - Generally, the main cause for airway obstruction is vomit.
  • Breathing - In kids with respiratory distress, ventilation and oxygen is required, alongside surfactant. However many normal premature babies need ventilation even if not suffering from rds.
  • Circulation - Support for circulation is in the area of blood transfusion, saline infusion and inotropic (slow the heart down) drugs.

Monitoring

Its pretty important to know what's going on with babies, as things can change pretty fast. If you ever go in SCBU (special care baby unit) there are about a hundred monitors randomly beeping and everyone just ignores them - you want to monitor heart rate, respiratory rate, temperature and O2 sats.

  • Warmth - Babies, especially premature ones are pretty rubbish at keeping in heat. Hypothermia is not something they tolerate well, so often a cot mounted heater or incubator is necessary.
  • Infection - Infants in intensive care are usually given broad spectrum antibiotics.
  • Try not to hurt them-painful/invasive procedures adversely affect oxygenation and circulation.