A healthy term neonate is born at a community hospital to a 26-year-old primigravida after an uncomplicated vaginal delivery. The prenatal laboratory parameters are normal amd negative for syphilis, human immunodeficiency virus, hepatitis B, and group B streptococci. The birthweight is 3.5 kg and the Apgar scores are 8 and 9 at 1 minute and 5 minutes, respectively. The neonate receives a vitamin K injection at the delivery suite. After an uneventful 1 hour postdelivery, the nurse notes that the infant appears “dusky” and “blue.” His temperature is 99.1°F (37.3°C), heart rate is 130 beats/min, mean blood pressure is 45 mm Hg, respiratory rate is 36 breaths/min, and oxygen saturation is 98%. Approximately 15 minutes later, he exhibits a gasping respiratory pattern, his oxygen saturation falls to 80%, and his respiratory rate is 64 breaths/min. Endotracheal intubation for respiratory distress is accomplished successfully. The mean blood pressure begins to fall,...
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June 2009
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June 01 2009
Index of Suspicion in the Nursery
Mathew George, MD;
Mathew George, MD
Harvard Medical Toxicology Fellowship Program, Childrens Hospital Boston, Boston, Mass
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Adina Sheroff, CSPI;
Adina Sheroff, CSPI
Harvard Medical Toxicology Fellowship Program, Childrens Hospital Boston, Boston, Mass
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Michele Burns Ewald, MD;
Michele Burns Ewald, MD
Harvard Medical Toxicology Fellowship Program, Childrens Hospital Boston, Boston, Mass
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Michael Shannon, MD
Michael Shannon, MD
Harvard Medical Toxicology Fellowship Program, Childrens Hospital Boston, Boston, Mass
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Neoreviews (2009) 10 (6): e303–e306.
Citation
Mathew George, Adina Sheroff, Michele Burns Ewald, Michael Shannon; Index of Suspicion in the Nursery. Neoreviews June 2009; 10 (6): e303–e306. https://doi.org/10.1542/neo.10-6-e303
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