Rationale

Neonatal distress is a relatively common occurrence. Failure to identify and appropriately manage an infant in distress in a timely manner can potentially lead to significant morbidity and mortality.

Causal Conditions

(list not exhaustive)

1. Prematurity

2. Pulmonary (e.g., meconium aspiration, pneumothorax)

3. Decreased respiratory drive (e.g., maternal medications, asphyxia)

4. Cardiovascular (e.g., anemia, congenital heart disease)

5. Infection

Key Objectives

In cases of a neonatal distress, the candidate will be able to assess the need for and initiate resuscitation, identify causal and ongoing pathologies, and determine ongoing needs, including whether the infant requires level 2 or level 3 neonatal intensive care.

Enabling Objectives

In cases of neonatal distress, the candidate will

1. list and interpret critical clinical findings, including

   1. physical signs and symptoms that necessitate immediate resuscitation;

   2. maternal and perinatal history;

   3. physical examination findings relevant to formulating a differential diagnosis;

2. list and interpret critical initial investigations targeted towards identifying an underlying cause (e.g., cord blood gas, blood glucose);

3. construct an effective initial management plan, including

   1. neonatal resuscitation;

   2. elements of ongoing supportive care, including;

      • thermoregulation;

      • fluid and electrolyte balance;

      • sepsis management;

      • cardiorespiratory support;

   3. appropriate communication with caregiver(s);

   4. appropriate consultation or referral.