IMPORTANT MEASURES IN NEONATES
 
 
*Room temperature from 22-24 c
*Incubator humidity 50%
*Incubator temperature 30-35 c
*Neonatal temperature 36.5-37 c
*Length of OTT = WT + 6
*Length of ETT = WT + 6 + 2
*Length of v umbilical 
    catheter in preterm 7cm, in fullterm 9cm (length x 0.18)
*Obstructive jaundice when direct bilirubin >20% of total bilir
*Heart rate  120-160 beat/minute
*Respiratory rate 40-60 breath/minute
*Mean time of blood transfusion 3 hours
*Double exchange transfusion = 170 x Wt
*Calories for fullterm 100kcal,for preterm 120kcal,SGA150
*Premature formula for babies<2kg till they reach 3 kg
*Baby does not tolerate feeding if residual >25% of previous feeding.
*Measure blood sugar in IDM on admission 1h,2h,3h,6,12,24 36,48
*Hypoglycaemia when blood sugar <40 mg/dl (normal 50-120).
*Hypomagnesaemia when serum level<1.2mg/dl (n=1.5-3.5).
*Hypocacaemia when blood ca < 7mg/dl.
*Stomach size 30-35 ml in full term, increase 20-25 monthly to reavh 100ml by the 3rd month,250 ml by tha age of1year
*Lenngth of stretched penis3.5 +/- 0.4 cm.
*Amount of urine 2-3ml/kg/h.
*Apnea..cessation of respiration>20sec+cyanosis /bradycardia
*Mean blood pressure in full term 80+-16 / 46+-16,     (abnormal >113---<40 )
*Any ophthalmia developing during the 1st 3 days of life should be considered gonococcal infection untill proved otherwise.
*Minimum discharge wt is 1.5kg.
*HR<100-+IPPV,<80->IPPV+Chest compression,<60 IPPV+Chest compression + medications.
*Chest compression just below nipple line , the sternum is compressed 3/4inch.
*Prophylactic iron therapy in LBW after doubling weight, for fullterm after 6mo.
*Adminster vit k & antibiotics eye drops withen one hour after birth .
*Lumbar puncture at left lateral position 1cm for term &1/2cm for preterm.
*For correction of CSF White count in traumatic,bloody tap - subtract 1WBC for every 1000 RBCS in CSF
 *Flow rate of 02 with incubator minimum of 5l/min,water bottle CPAP 5-10L/min,face mask  4l/min,nasal prong 0.5-2l/min
 

 *Adjusted Ca = total serum Ca mg% +0.2(4.7-albumin gm/dl) {N >8.4 - < 8.4=hypocalcemia) *Serum osmolarity= 2Na+BUN/2.8+Glucose/18 ( 300 mosm /kg)
*Packed CELLS= HB deficit x wt X4 *Whole blood = HB deficit x wt X6
*bicarbonate = BExwtx 0.15 *K replacement = Deficit X wt X 0.75
*partial exchange transfusion = 20-30ml/kg plasma or saline 
*calories   in milk = ml/day x 0.67   in special preterm formula (ml/dayx0.8 )  in CHO = %Dextrose x ml/day x 0.034 in protein= %aminoacidxml/day x 0.04
 
 
 
Dr.Kamel Hassan
Best Regards
 
 
 

 
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