Author: Melanie Hawkins / Editor: Steve Fordham / Reviewer: Nadarajah Prasanna, Mark Brown / Codes: NeoC2, NeoC5, RP7, RP8, SLO5 / Published: 22/12/2023
A 3-day-old baby girl is brought to the emergency department (ED) by her distressed mother with complaints about the baby’s shivering and lethargy.
Background: Full-term vaginal delivery at home, second baby. Mum is breastfeeding and has been experiencing problems getting the baby to latch on. Over the last 24 hours the baby has become increasingly sleepy, waking for short periods and has not fed properly for 8 hours.
On examination: The baby is very floppy, feels cool and does not respond to examination.
- Resp rate: 75
- Heart rate 146
- Sats 98% (air)
- Temperature 36.3
- Head: normocephalic, anterior fontanelle soft and slightly retracted, no dysmorphic features
- Pupils: Equal and reactive Ears: NAD
- Mouth: Mucous membranes are slightly dry
- Skin: Cool, dry, intact, no rashes, slight tenting, capillary refill 4 seconds
- Chest: Clear to auscultation bilaterally Heart: Sinus rhythm, no murmurs
- Back: Normal, no sacral dimpling or hair tufts
- Abdomen: Soft, non-distended, no apparent tenderness, no hepatosplenomegaly, bowel sounds are present
- Neurological: Minimal response to tactile stimuli, intermittent jittering