Author: Melanie Hawkins /Â Editor: Steve Fordham / Reviewer: Nadarajah Prasanna, Mark Brown / Codes: NeoC2, NeoC5, RP7, RP8, SLO5 /Â 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
24 Comments
Thanks, really useful module
very useful
Very helpful and informative
Point is clear and well delivered
Useful refresher
Really useful info about neonatal hypoglycemia
great reminder and an absolutely important lesson that we must not forget glucose ever
A useful case study – thank you
Useful revision of an important topic
very educational. thanks
Useful
very relevant
ABCDE and never forget the glucose! Very interesting case presentation!
Useful info
very useful
good revision
useful revision of a very important topic.
Thank you
Straight forward presentation. Hope to have more complex neonatal presentation cases.
useful module
Interesting case.
Excellent Case.
Really nice, informative and interesting.
Excellent
Very useful case – excellent reminder about the aetiologies of neonatal hypoglycaemia.