PRE-TRANSPORT / POST-RESUSCITATION

STABILIZATION CARE OF SICK INFANTS

Sjarif Hidajat Effendi

Department of Childhealth, Hasan Sadikin General Hospital-
University of Padjadjaran, Bandung, Indonesia
 INTRODUCTION

GUIDELINES assesment
stabilization

HOSPITALS DELIVERY SERVICES

Need to prepare
HOSPITALS without delivery services.
S MNEMONIC

T To ease of remembering
what to do

A Created to assist with information recall

standardize
B organize care

L
E
S SUGAR & SAFE

T IV Fluid therapy
A For sick infants/infant at risk

B Safe patient care

L
E
S TEMPERATURE

T Special thermal needs

A hypothermia
B
L
E
S AIRWAY

T Evaluation of:
RD

A Airway challenges

Detection + th/pneumothorax

Blood gas

B Respiratory failure

Respiratory support

L ETT

Ventilator settings

E Chest x-ray
S BLOOD PRESSURE

T Evaluation + treatment of shock

A
B Hypovolemic Cardiogenic Septic

L
E
S LAB WORK

T
Infection
A

antibiotic treatment
B
L
E
S
T
Support Families
A
B
L
E
60-80 ml/kg/day
Axillar temperature goal 36,5-37,50C
Axillar temperature

(if available)
skin
Kangoroo Mother Care
Kangoroo Mother Care
(if available)
 RESPIRATORY DISTRESS EVALUATION
Down Score
0 1 2
Respiratory < 60x/minute 60-80 x/minute >80x/minute
Rate
Retraction No retraction Mild retraction Severe
Retraction
Cyanosis No cyanosis Cyanosis Cyanosis (+)
disappeared with O2 with O2
Air Entry (+) Air entry decrease NO air entry

Gasping No gasping heard by stethoscope Heard without

any tools

31
 RESPIRATORY DISTRESS EVALUATION
Down Score
32

Score < 4 Mild Respiratory Distress

Score 4 5 Moderate Respiratory Distress

Score > 6 Severe Respiratory Distress (blood

gas analysis should be performed)
Apnoea Definition

Apnoea is defined as no inspiratory gas flow for

20 seconds or shorter if associated with
bradycardia (<100bpm), cyanosis or pallor.

Neonatal Handbook, Royal Women Hospital 2005

THANK YOU
30-60
60-80 ml/kg/day delivers a
glucose dose of 4,2-5,5mg/kg/min

60-80

Kg x (60-80) ml/hr
24
 60-80 ml/kg/day

30-60
 Aminophylline
Neonatal Apnoea
Loading dose
IV : 6 mg/kg/dose
Maintenance dose
Commence
1 kg 24 hrs after loading
1 kg 12 hrs after loading
IV :
Age 7 days 2.5 mg/kg/dose 12 hrly
Age 8-14 days 3 mg/kg/dose 12 hrly
Age >14 days4 mg/kg/dose 12 hrly
Caffeine Citrate
Neonatal Apnoea
Loading dose

IV, Oral : 20 mg/kg

Maintenance dose

(commence 24 hrs after loading dose)

IV, Oral : 5 mg/kg/daily
Maintenance dose can be increased to a maximum of
10 mg/kg/day
88-92%
LAB WORK
(if available)
(Dobutamine drip)
Dobutamine hydrochloride
 Dopamine/dobutamine Preparation

Dopamine/ Dobutamine
How to make 30mg/kg in 50 ml

Dose equivalent 1 ml/hr : 10 microgram/kg/min

Dose range 5-20 microgram/kg/min

Dopamine/Dobutamine Infusion Rules
Axillar temperature