mid2004 neonatal pain and recognising sepsis

neonatal sepsis types 

• early onset sepsis 

• late onset sepsis 

early onset sepsis 

• usually acquired from the birth canal 

• within the first 48hrs 

• mainly GBS or gram neg bacteria

late onset sepsis

• after the first 48 hrs

• usually due to organisms in the environment

• staphylococcus usually

thermo signs n symptoms for sepsis 

• unstable temps 

• fever

• hypothermia 

neuro signs n symptoms for sepsis 

• lethargy 

• jitterness 

• seizures 

• bulging fontanelles 

• high pitched cry

resp signs n symptoms for sepsis 

• tachypnoea 

• nasal flaring 

• expiratory grunt 

• rib retractions 

• cyanosis 

cardio signs n symptoms for sepsis 

• tachycardia 

• arrythmia 

• hypo-hypertension 

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git signs n symptoms for sepsis 

• poor feeding

• vomiting

• diarrhoea

• abdominal distension

skin signs n symptoms for sepsis 

• rashes

• jaundice

immunoglobin

an antibody-mediated reponse that results from a previous exposure

types of immunoglobin

1. IgG

2. IgA

3. IgM

4. IgE

5. IgD

IgG immunoglobin

• crosses the placenta in the 3rd trimester 

• immunity against bacteria and viral pathogens 

• passive immunity to organisms that mom is also to

IgM immunoglobin 

• doesnt cross the placenta

• made in fetus 

• direct immunity 

• produces in response to an organism 

IgA immunoglobin 

• from colostrum and milk not placenta 

• common in GIT and resp tract 

• not detectable till 3 weeks post birth 

IgE immunoglobin

• small presence

• major role in allergic reactions

IgD immunoglobin

• very small amts 

• not well understood

risk factors for infection AN

1. poor AN care

2. low SES

3. poor nutrition

4. substance abuse

5. often abortion 

6. previous STI 

7. previous infant w infection 

risk factors for infection IP

1. PROM 

2. GBS pos

3. low GBS antibodies maternally 

4. fetal tachy 

5. premature labour 

6. UTI 

7. maternal fever

8. invasive IP procedures

9. maternal tachy

risk factors for infection neonatal

1. premature

2. LBW

3. asphyxia 

4. meconium staining

5. resus

6. congenital anomalies

7. males

8. multis

asphyxia

prolonged lack of oxygen to a newborn before, during, or after birth

risk factors for infection environmental

1. hosp admission

2. length of stay

3. invasive procedures eg resus or IV

4. common use of broad antis

5. use of ventilation or incubators

transcytosis

antibody IgG is transported across epithelial cells to perform functions like protecting the fetus or the newborn

role of IgA in colostrum and breast milk 

forming the first line of defense against pathogens in the infant's mucosal surfaces, such as the gut and respiratory tract