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Thursday 27 October 2016

Collapsed Neonates

Resuscitate
As per appropriate
Adrenaline 10mcg/kg

Prostin -  
    - 5 ng/kg/min if clinically well
    - 20 ng/kg/min if unstable or absent femoral pulses
    - 50-100 ng/kg/min if no response
Apnoea common: 1st hr of Rx, dose
Hypotension may occur with high dose

Prostin
- 5 ng/kg/min if clinically well
- 20 ng/kg/min if unstable or absent femoral pulses
- 50-100 ng/kg/min if no response
Apnoea common: 1st hr of Rx, dose

Hypotension may occur with high dose

Think about Causes
Infection
Group B strep, E Coli - PROM, maternal GBS, fever in labour
Herpes Simplex - GCS, coagulopathy, ALT, family cold sores
MRSA - Unresponsive 1st line antibiotics,+ contact

Cardiac
Coarctation aorta - Systolic arm/leg gradient > 20 mmHg
Hypoplastic Left heart - Poor pulses –may be pink= pulm. overcirculation
Transposition (TGA) - Preductal sats < post ductal sats
TAPVD (obstructed) - Shocked & cyanosed/CXR plethoric
SVT  - HR>220 despite fluid, f ixed HR, narrow QRS
Myocarditis - Cardiac failure, tachycardia, small QRS

Injury 
Intracranial bleed  - Focal neuro signs, fontanel le , retinal bleeds
Intrabdominal bleed - Unexplained anaemia, abdominal bruising

Cardiac

Metabolic
Vomiting, reduced GCS, hypoglycaemia
Stop the feeds. Give fluid and dextrose as highly likely to be fluid depleted

References
http://paediatricem.blogspot.co.uk/search/label/NLS
http://www.rcemlearning.co.uk/references/congenital-heart-disease/ 
http://www.rcemlearning.co.uk/modules/the-shocked-neonate/ 
http://www.rcemfoamed.co.uk/portfolio/metabolic-babies-in-the-ed-easy-as-1-2-3/ 

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  2. Pedicuristry imstruments hurts too much , specially Extracting Forceps, i have experienced it before.

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  7. First, I want to complement this page administrator for creating this platform for us to express our feelings. Herpes is a serious and recurring disease which can't be cured through drugs or injections by the American doctors but the best way to deal with herpes is by taking natural herbs medicine from DR. ISHIAKU the greatest herbalist doctor in the world and is only few American doctors that know about this herbal medicine from Dr ISHIAKU .. I have read about Dr ISHIAKU the great herbalist doctor from African who can cure disease with his powerful herbal medicine. for the people suffering from the following diseases, Herpes,HIV/Aids, Cancer, Also, Hepatitis, Diabetes, Hpv, Infections ETC should contact him for his herbal medicine because i am a living testimony and i was cured of herpes. Although, i sent him what he requested and he sent me his medicine through DHL courier delivery company which i took for 10 days and today when i went for test i was tested herpes negative. you can reach him through his email (ishiakuherbalcure@gmail.com) or WhatsApp him at +2348180828544

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  12. Never give up in life they all say no cure to HSV 2 which is a big lie I have pass through many process also i never believe there is really cure to HERPES until I meet Dr Shaibu the doctor that have been helping many people for many years, I came across this doctor online when I was searching for cure online I found out about this man, and to my greatest surprise this man have the herbal medicine which I have been looking for years I explain my problem to him through the email I found on someone who testify about him also, Dr Shaibu write me a reply and explain how the process work so after ordering for the medicine I got it within 4 days and I took it according to the way Dr Shaibu instructed, I was so happy after two week I took the medicine there was very big change in my health when I was done with the process I go for test, I found out I am negative that was the day I have the tears of joy you can also get in contact with my doctor through his email now drshaibuabacha@gmail.com or WhatsApp him +2349051727475. And He also have herbs medicine to cured the following diseases; eczema,urethra wart,chronic problems.Herpes, Cancer, Als,Hepatitis, Diabetes, HPV,Infections,ulcer  ETC

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  16. I have been suffering from (HERPES) disease for the last four years and had constant pain, especially in my knees. During the first year, I had faith in God that I would be healed someday.This disease started to circulate all over my body and I have been taking treatment from my doctor, a few weeks ago I came on search on the internet if I could get any information concerning the prevention of this disease, on my search I saw a testimony of someone who has been healed from (Hepatitis B and Cancer) by this Man Dr. Silver and she also gave the email address of this man and advise we should contact him for any sickness that he would be of help, so I wrote to Dr. Silver telling him about my (HERPES Virus) he told me not to worry that I was going to be cured!! hmm i never believed it,, well after all the procedures and remedy given to me by this man few weeks later I started experiencing changes all over me as the Dr. assured me that I have cured, after some time i went to my doctor to confirmed if I have been finally healed behold it was TRUE, So friends my advice is if you have such sickness or any other at all you can email Dr. Silver (drsilverhealingtemple@gmail.com) sir I am indeed grateful for the help I will forever recommend you to my friends!!! with your lovely Email Address ( drsilverhealingtemple@gmail.com

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  18. I am here to share testimony on how Dr.Md Azhar herbal remedy cured me from herpes I have been suffering from herpes for more than 2 year until I met a friend who directed me to Dr. Md Azhar i had doubts at first but now I am a living testimony, after taken the herbs he gave to me l started having some changes within my body and now I am totally cured from herpes. He also have cure for several kinds of diseases and infection contact him today and be restored to your normal self again, God bless you Dr. Md Azhar you can reach him on whatsapp +2349051727475 or  dr.mdazharsolutionhome@gmail.com.

    ReplyDelete
  19. I am here to share testimony on how Dr.Md Azhar herbal remedy cured me from herpes I have been suffering from herpes for more than 2 year until I met a friend who directed me to Dr. Md Azhar i had doubts at first but now I am a living testimony, after taken the herbs he gave to me l started having some changes within my body and now I am totally cured from herpes. He also have cure for several kinds of diseases and infection contact him today and be restored to your normal self again, God bless you Dr. Md Azhar you can reach him on whatsapp +2349051727475 or  dr.mdazharsolutionhome@gmail.com.

    ReplyDelete
  20. First, I want to complement this page administrator for creating this platform for us to express our feelings. Herpes is a serious and recurring disease which can't be cured through drugs or injections by the American doctors but the best way to deal with herpes is by taking natural herbs medicine from DR. ISHIAKU the greatest herbalist doctor in the world and is only few American doctors that know about this herbal medicine from Dr ISHIAKU .. I have read about Dr ISHIAKU the great herbalist doctor from African who can cure disease with his powerful herbal medicine. for the people suffering from the following diseases, Herpes,HIV/Aids, Cancer, Also, Hepatitis, Diabetes, Hpv, Infections ETC should contact him for his herbal medicine because i am a living testimony and i was cured of herpes. Although, i sent him what he requested and he sent me his medicine through DHL courier delivery company which i took for some days and today when i went for test, i was tested herpes negative. you can reach him through his  WhatsApp him at +2348180828544

    ReplyDelete
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  22. I have been suffering from (HERPES) disease for the last four years and had constant pain, especially in my knees. During the first year, I had faith in God that I would be healed someday.This disease started to circulate all over my body and I have been taking treatment from my doctor, a few weeks ago I came on search on the internet if I could get any information concerning the prevention of this disease, on my search I saw a testimony of someone who has been healed from (Hepatitis B and Cancer) by this Man Dr. Silver and she also gave the email address of this man and advise we should contact him for any sickness that he would be of help, so I wrote to Dr. Silver telling him about my (HERPES Virus) he told me not to worry that I was going to be cured!! hmm i never believed it,, well after all the procedures and remedy given to me by this man few weeks later I started experiencing changes all over me as the Dr. assured me that I have cured, after some time i went to my doctor to confirmed if I have been finally healed behold it was TRUE, So friends my advice is if you have such sickness or any other at all you can email Dr. Silver (drsilverhealingtemple@gmail.com) sir I am indeed grateful for the help I will forever recommend you to my friends!!! with your lovely Email Address (drsilverhealingtemple@gmail.com or whatsapp on +2348123877102I have been suffering from (HERPES) disease for the last four years and had constant pain, especially in my knees. During the first year, I had faith in God that I would be healed someday.This disease started to circulate all over my body and I have been taking treatment from my doctor, a few weeks ago I came on search on the internet if I could get any information concerning the prevention of this disease, on my search I saw a testimony of someone who has been healed from (Hepatitis B and Cancer) by this Man Dr. Silver and she also gave the email address of this man and advise we should contact him for any sickness that he would be of help, so I wrote to Dr. Silver telling him about my (HERPES Virus) he told me not to worry that I was going to be cured!! hmm i never believed it,, well after all the procedures and remedy given to me by this man few weeks later I started experiencing changes all over me as the Dr. assured me that I have cured, after some time i went to my doctor to confirmed if I have been finally healed behold it was TRUE, So friends my advice is if you have such sickness or any other at all you can email Dr. Silver (drsilverhealingtemple@gmail.com) sir I am indeed grateful for the help I will forever recommend you to my friends!!! with your lovely Email Address (drsilverhealingtemple@gmail.com or whatsapp on +2348123877102

    ReplyDelete
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  25. Dr. Riaria cured my herpes virus that have been in my body since two years, ever since then my life has been incomplete, I have used so many drugs that was prescribed to me by doctors, but it didn't cure my herpes virus, i was checking for solution on the internet then I miraculously came across Dr. Riaria the powerful herbalist that  can cure herpes infection, then I contacted him through his email, I explained everything to him and he prepared a herbal medicine and sent it to me through FedEx, which I took for 14 days with the instruction he gave me, and when I did a test in the hospital my result came out negative it was the happiest day of my life that am cure from HSV 2,  are you also suffering from same virus or another diseases you can simply contact him via email: drriaria@gmail.com  you can also call or WhatsApp him on: +2349134987375.  

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