EARLY CLINICAL SIGNS OF DETERIORATION IN NEWBORNS

Why Newborns are more susceptible to illness

• Change over from Intra-uterine to extra-uterine life

• Immature and slow responding Immune System• Poor Skin barrier• Umbilical Stump• Poor Blood brain barrier

• Maternal History of GBS• PROM more than 18 hours• Maternal Fever• Maternal UTI• Chorioamnionitis

Infants at Risk

Careful observation and appropriate action can save lives

• Proper training• Confident finding will lead to successful treatment• Identifying normal values at the earliest

Newborn Early Warning Score

Remember ABC My Nursery Temperature !!

• Air way Signs• Breathing Signs• Cardiac Signs• Metabolic Signs• Neurologic Signs• Temperature

Air way, Breathing Signs

• Apnea• Tachypnea• Grunting• Shallow breathing• Inter coastal, sub coastal or

Supra-sternal recession

Cardiac Signs

• Tachycardia• Bradycardia• Hypoxemia• Hypotension• Pallor• Poor capillary perfusion• Edema

Metabolic Signs

• Hypoglycemia

• Hyperglycemia

• Metabolic acidosis

• Jaundice

Neurologic Signs

• Lethargy

• Irritability

• Impairment of consciousness

• Hypotonia

• Buldging anterior fontanalle

• Seizure or any subtle movements

Temperature Instability

• Hyperthermia

• Hypothermia

Evaluation

• Know the Normal Values- most important!

• RR, HR, SPO2, Capillary Filling time, BP, Temperature, Blood Sugar

References

• www.nhs.uk• American Nurse Today

Journal 2012 • Medscape Article 2012

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