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RD- 1
Respiratory distress
Retractions
Grunt
+ Cyanosis
* Tachypnea
Teaching Aids: NNF
RD- 2
Pulmonary
Metabolic-Hypoglycemia, acidosis
RD- 3
(RDS)
RD- 4
Tracheo-esophageal fistula
Diaphragmatic hernia
Lobar emphysema
Choanal atresia
RD- 5
Onset of distress
Gestation
Antenatal steroids
Asphyxia
RD- 6
Neurological status
Hepatomegaly
Cyanosis
Features of sepsis
RD- 7
1.
Resp. rate
<60
2.
Central
None
cyanosis
1
60-80
None with
2
>80
Needs
40% FiO2
>40% FiO2
1.
Retractions
None
Mild
Severe
2.
Grunting
None
Minimal
Obvious
3.
Air entry
Good
Decreased
Very poor
RD- 8
Air entry
Mediastinal shift
Adventitious sounds
Hyperinflation
Heart sounds
RD- 9
- Asphyxia, metabolic
causes, hypothermia
Anytime
- Pneumonia
RD- 10
- TTNB, polycythemia
- MAS, asphyxia,
malformations
- Cardiac
hepatomegaly
Late sick with shock
- Acidosis
Anytime
- Pneumonia
RD- 11
Obvious malformation
Scaphoid abdomen
Frothing
History of aspiration
RD- 12
Investigations
Gastric aspirate
Polymorph count
Sepsis screen
Chest X-ray
RD- 13
Shake test
Take a test tube
Mix 0.5 ml gastric aspirate +
0.5 ml absolute alcohol
Shake for 15 seconds
Allow to stand 15 minutes for
interpretation of result
RD- 14
Specific
RD- 15
Oxygen therapy*
Indications
Cyanosis
Method
RD- 16
Pulse oximetry
RD- 17
Pre-term baby
Radiological evidence
RD- 18
X-ray - RDS
RD- 19
Pathogenesis of RDS
Alveolar collapse
Respiratory failure
RD- 20
Prematurity
Cesarean born
Asphyxia
Maternal diabetes
PROM
IUGR
Steroids
RD- 21
Antenatal corticosteroid
- Simple therapy that saves neonatal lives
RD- 22
Cost
Prophylactic Vs rescue
RD- 23
Rescue therapy
Any neonate diagnosed to have RDS
Dose 100mg/kg phospholipid Intra tracheal
Teaching Aids: NNF
RD- 24
RD- 25
Post term/SFD
Hyperinflated chest
RD- 26
X-ray - MAS
RD- 27
MAS - Prevention
Oropharyngeal suction before delivery of
shoulder for all neonates born through
MSAF
Endotracheal suction for non vigorous*
neonates born through MSAF
*Avoid bag & mask ventilation till trachea is
cleared
Teaching Aids: NNF
RD- 28
Diagnosis by exclusion
Management: supportive
Prognosis - good
RD- 29
X-ray- TTNB
RD- 30
Congenital pneumonia
Predisposing factors
PROM >24 hours, foul smelling liquor,
Peripartal fever, unclean or multiple per
vaginal
Treatment
Thermoneutral environment, NPO, IV
fluids, Oxygen, antibiotics(Amp+Gentamicin)
Teaching Aids: NNF
RD- 31
RD- 32
Nosocomial pneumonia
Risk Factor : Ventilated neonates
: Preterm neonates
Prevention
Antibiotics
Teaching Aids: NNF
: Handwash
: Use of disposables
: Infection control
measures
: Usually require higher
antibiotics
RD- 33
Myocardial dysfunction
Cerebral edema
Metabolic acidosis
RD- 34
Pneumothorax
Etiology
Spontaneous, MAS, Positive pressure
ventilation (PPV)
Clinical features
Sudden distress, indistinct heart sounds
Management
Needle aspiration, chest tube
Teaching Aids: NNF
RD- 35
X-ray - Pneumothorax
RD- 36
Persistent pulmonary
hypertension (PPHN)
Causes
Primary
Secondary: MAS, asphyxia, sepsis
Management
Severe respiratory distress needing
ventilatory support, pulmonary
vasodilators
Poor prognosis
Teaching Aids: NNF
RD- 37
Respiratory distress
(needing referral)
RDS (HMD)
MAS
Surgical or cardiac cause
PPHN
Severe or worsening distress
RD- 38