NEONATOLOGY

Jaundice in a Neonate
Section A Age Section B

Symptoms clerking
Duration of the yellowness of the eyes Is it deepening or constant ? Yellowness in any other part of the body Fever, if yes clerk - Ear pulling or discharge Refusal of feeds Is the child sucking well? Irritability or crying e cessively !o"iting, #bdo"inal distension, Diarrhoea $olour of stool, does it float on water %rine colour, fre&uency Is the child less active?

Associated Symptoms

Aetiology
'lood transfusion (other)s blood group*Rhesus Is the baby on breast "ilk? 'reast"ilk +aundice Is the baby on any drug? ,erbs ingestion -reservation of clothes .baby)s nappy/ with naphthalene balls .ca"phor/ $ontact with a person with yellowness of eyes Fa"ily history

-regnancy, 'irth 0 1eonatal ,istory o Detailed

Fa"ily history #ny history of si"ilar illness in the siblings

Treatment
3ection $ 2reat"ent so far

Pregnancy, Birth & Neonatal History Pregnancy

-arity #ntenatal care where did you book? Duration of pregnancy to rule out preterm Fever 0 Rash during first tri"ester Drug ingestion during pregnancy Radiation 2etanus to oid ,istory of antepartu" hae"orrhage

Delivery
4here Duration of seeing or passing water .a"niotic fluid/ -R5( 4as the water foul-s"elling or "econiu" stained .greenish/ Duration of labour (ode of delivery 3!D, forceps to rule out intracranial haemorrhage 4as the birth induced? o ytocin Did the child cry i""ediately after birth or after resucitation 'irth weight $ord care

Immunisation
Section D Did the child receive any i""uni6ation #t birth, 7 "onths 4hat route*site of ad"inistration? oral or I( 4here is the i"unisation card? #ny adverse reactions If -atient was not i""uni6ed, ask why?

De elopmental !ilestone Nutritional history

Feeding since birth breast "ilk * cow"ilk, Fre&uency of feeds8 Refusal of feeds - Is the child sucking well?

"amily & Social History

(onoga"ous or polyga"ous Father 0 (other)s age, occupation, educational status 'irth order of the patient 3iblings 1u"ber, alive 0 well Death age 0 cause of death #ny si"ilar illness

Treatment
Treatment offered so far

Ina#ility to suck $ Neck sti%%ness &Neonatal tetanus

Section A Section B

Symptoms clerking
Duration

Associated Symptoms
Fever autonomic sign Any spas"s unprovoked or provoked by light sound - duration ! to first sign trismus" - Fre#uency - Aggravating or relieving factors - $o% long does each episode last& 'eriod bet%een the inability to suck and the first spasm 'eriod on

onset Triggering factors e(g bright light touching noise( Ear pulling or discharge )rritability or crying Breathlessness from aspiration *aundice +hen last did the child eat& - hypoglycaemia

Aetiology Ear discharge ,hronic suppurative otitis media ,ircumcision Ear piercing or tribal-scarification marks Blood transfusion Trauma

'regnancy birth . /eonatal history

'regnancy 'arity 0ength of pregnancy A/, %here . %hen& TT Drug ingestion during pregnancy $istory of antepartum hemorrhage intrauterine hypo1ia $istory of fever or rash T23,$ES 4se of social drugs !drug %ithdra%al" alcohol intake Delivery Duration of seeing or passing %ater !amniotic fluid" '325 +as the %ater foul-smelling or meconium stained !greenish" Duration of labour 5ode of delivery Birth %eight ,rying after birth )mmediately or after resuscitation +hat %as used to cut the cord& ,ord care /eonatal *aundice Treatment so far