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    STP Shock PreFinal

    Uploaded by

    Suman Mondal
    Shock

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    STP Shock PreFinal

    Uploaded by

    Suman Mondal
    2 views2 pages
    Shock

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    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    Shock

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    2 views2 pages

    STP Shock PreFinal

    Uploaded by

    Suman Mondal
    Shock

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 2

    Standard Treatment Protocol for management of common newborn conditions in small hospitals

    (Adapted from WHO Guidelines)

    Shock in Newborn

     Weak & fast pulse ( HR>180/min) AND


     Extremities cold to touch AND
     Capillary Refill Time >3 sec
    With or without the following signs:
     Colour- very pale
     Lethargy, not arousable on stimulation

    Provide warmth
    Secure airway
    Support breathing, circulation and temperature
    Start oxygen, if saturation (<90%) is low
    Measure blood glucose; correct hypoglycemia (Follow STP)

    If bleeding is NOT the likely cause If bleeding is the likely cause

     Establish IV access
     Establish IV access
     Give IV normal saline or Ringer Lactate 10 ml/kg
     Give IV normal saline or Ringer Lactate 20 ml/kg
    body weight over 10 min
    body weight over the first hour
     If no improvement, repeat fluid of 10 ml/kg once
     Give IV 10% Dextrose at maintenance rate
    after 20 minutes as above
     Treat for Sepsis (Follow STP)
     Immediately give a blood transfusion using type
     Continue O2 as required
    O, Rh negative blood
     Give Vitamin K 1 mg IV

    Monitor hourly (Panel 2):


    • Heart rate, oxygen saturation
    Determine Diagnosis (Panel 1)
    •Capillary refill time
    •Urine output
    •Sensorium

    If signs of shock improve If signs of shock persist

     Continue maintenance IV fluid as per  Continue IV Fluid and O2


    weight and day of life (Follow STP)  REFER
     Reassess above parameters hourly
     Give specific treatment based on
    diagnosis (Follow specific STP) 1

    For additional / next level management please refer to WHO Guidelines (Managing Newborn Problems and Pocket Book
    of Hospital Care of Children), http://www.ontop-in.org/sick-newborn/, http://www.newbornwhocc.org/
    Standard Treatment Protocol for management of common newborn conditions in small hospitals
    (Adapted from WHO Guidelines)

    Panel 1: Diagnostic clues based on history and clinical examination

    Cause History / Examination

    Blood loss Antepartum hemorrhage


    Blood loss internal/external Follow STP on Emergency
    Age day 1 Management – Sheet A

    Asphyxia Need for Resuscitation for poor respiratory efforts at birth


    Hypoxic ischemic encephalopathy (See STP for Management of
    asphyxiated neonates)
    Sepsis Predisposing factors for infection
    Age > day 3 Follow STP

    Severe dehydration Loose stool, vomiting, failure to feed + Signs of dehydration


    Cardiac Term baby; normal at birth
    Age day 3-4
    Look for feeble or delayed femoral pulse, cardiac murmur
    (coarctation of aorta)
    Persistent Pulmonary Meconium stained term baby
    REFER
    Hypertension of the Age day 1-3
    Newborn (PPHN)

    Panel 2: Monitoring of baby with shock

    Signs At admission 1 hr 2 hr 3 hr 4 hr

    Heart Rate/min
    Capillary refill time
    Urine output
    Sensorium
    Temperature difference
    (core-extremities)

    For additional / next level management please refer to WHO Guidelines (Managing Newborn Problems and Pocket Book
    of Hospital Care of Children), http://www.ontop-in.org/sick-newborn/, http://www.newbornwhocc.org/

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