Triaging sick newborn babies
- Introduction...
- 1. Triaging...
- 2. Categorizing th...
- 3. Examples of gro...
- 4. Process of tria...
- 5. Emergency manag...
- 6. Emergency manag...
- 7. Triaging: Other...
Introduction
DR. COL K. VENKATNARAYAN
MD, DNB, MNAMS, DM (Neonatology)
Head & Associate Professor
Command Hospital
Pune
1. Triaging
► Definition
♦ The word “triage” means sorting
♦ Process of rapidly screening sick neonates
► Place of triaging
♦ The reception and resuscitation area/ casualty
► Staff
♦ Trained staff and most experienced doctor
2. Categorizing the groups
► Emergency cases
♦ Require urgent intervention and emergency treatment
♦ Need to be admitted in the SNCU
► Priority cases
♦ Need immediate assessment and priority treatment
♦ Need to be admitted in the SNCU
► Non-urgent cases
♦ Need assessment
3. Examples of groups of triaging
4. Process of triaging: Assessment for emergency signs
► Temperature
♦ Assess, if baby has hypothermia
► Airway and breathing
♦ Apnea/ gasping respiration
♦ Respiratory distress (RR> 60/min, retractions, grunting)
♦ Central cyanosis
► Circulation
♦ CFT > 3 sec
♦ Tachycardia and weak pulse
► Sensorium
♦ Assess response to stimulus
♦ Look for convulsions
5. Emergency management: Triaging
► Manage temperature
♦ Re warm the baby
♦ Maintain temperature: 36.50C - 37.50C
♦ Keep the baby dry and the head, hands and feet covered
► Maintain airway
♦ Place shoulder roll: Baby in “sniffing” position
♦ Clear secretions, if required
6. Emergency management: Triaging-01
► Assist breathing
♦ Start with 1-2 L/min by nasal cannula or 5-6 L/ min by
hood, if baby is distressed
♦ Give PPV, if baby is gasping or apneic
♦ Connect to pulse oximeter
► Support circulation
♦ Give bolus of NS 10 ml/kg over 30 min
♦ Repeat, if response is poor
♦ Blood transfusion, if bleeding is the cause
♦ Start inotropes, if poor response
7. Triaging: Other key issues
Baby may have more than one underlying
condition to treat, so look for all
conditions and treat them