immediate care for symptomatic infant

Immediate Care for Symptomatic infants

• Investigations are necessary as indicated and include:
• Blood gases.
normal range:

• Blood glucose (dextrostix)
hypoglycemia if cbs < 2.6 mmol/L but some centre they use cbs 3.0. look for any jitteriness of upper or lower limbs. will be discussed later..

• Full blood count with differential WBC and IT ratio (if possible)
normal range fbc:

• Blood culture.
• CXR (if respiratory signs and symptoms are present)
• Start on 10% dextrose drip.
• Correct anaemia.
usually we give packed cell 10ml/kg...and iv lasix 1mg in between transfusion.
frusemide dose:   0.5 - 1.0  mg/kg intravenously over 20 minutes.

• Correct hypotension (keep mean arterial pressure (MAP) > gestational age
(GA) in wks). Ensure hyperventilation is not present (a cause of hypotension).
If the baby has good tone and is active, observe first as the BP may rise after
first few hours of life towards a MAP approximating GA in weeks.
• Correct hypovolaemia: Give 10 ml/kg of Normal Saline over 20-30 mins, or
packed cells if anaemic. Avoid repeat fluid boluses unless there is volume loss.
• Start inotrope infusion if hypotension persists after volume correction.
• Start antibiotics after taking cultures e.g. Penicillin and Gentamycin
• Start IV Aminophylline or caffeine in premature infants <32-34 weeks.
• Maintain SaO₂ at 89-92% and PaO₂ at 50 –70 mmHg.