Examination of the Newborn Introduction and pre-examination

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Presentation transcript:

Examination of the Newborn Introduction and pre-examination Chris Kingsnorth

Before We Begin

Overview 4 presentations: Introduction and pre-examination Examination part 1: Eyes, heart, hips and testes Examination part 2: Top-to-toe Post-examination

Overview What is the Newborn and Infant Physical Examination programme? Why are Newborn Examinations performed? Information gathering Preparing to examine

Newborn and Infant Physical Examination (NIPE) Programme National screening programme 2 examinations: 1st (‘Newborn’): <72hrs 2nd (‘Infant’): Ideally at 6-8wks (must be <10wks)

Newborn and Infant Physical Examination (NIPE) Programme Head-to-toe check Aim = to identify problems requiring timely intervention (i.e. within wks) Main focus = heart, hips, eyes +/- testes Chance to document birthmarks

Information Gathering Medical Hx Parental concerns Feeding Bowels and urine

Information Gathering: Medical Hx Mum: Prepartum/ intrapartum/ postpartum Child: Antenatal/ perinatal/ postnatal Family: 1st degree relatives (i.e. siblings and parents)/ others Check antenatal (‘handheld’) notes and perinatal documentation

Information Gathering: Mum’s Medical Hx Conditions existing prior to pregnancy Conditions acquired during or continuing into pregnancy (infections/ (pre)eclampsia/ gestational diabetes/ Risk factors in perinatal period (PROM/ maternal pyrexia/ intrapartum Abx/ Emergency C-section or assisted delivery/ meconium stained liquor) Health since giving birth (blood loss, infections, psychological status)

Information Gathering: Baby’s Medical Hx

Information Gathering: Family Hx

Information Gathering: Other Birth-weight/ head circumference Feeding well (tired/ breathless?) Meconium passed? Urine passed? (if male ?nature of urine stream)

Explanation and Parental Concerns Briefly explain reason for examination and what it involves Explain that not all abnormalities present at birth and others may be picked up at 6-8 week check Address any parental concerns Ask permission to examine Have you noticed anything that worries you? Have you noticed any birthmarks?

Preparing to Examine Remember your ophthalmoscope Turn on the light Mum and baby’s privacy is important Keep baby as warm as possible Firm flat surface must be available for hip examination

Summary NIPE newborn check = head to toe screening examination at <72hrs to identify problems requiring timely intervention Review notes thoroughly prior to examination Address parental concerns Proper preparation and explanation will save you and the parents time and hassle

What Now? Download slides + checklist Online MCQ: https://www.goconqr.com/en-GB/p/3867979-Examination-of-the-Newborn--1--Introduction-and-Pre-examination-quizzes Request a Podcast/ ask a question Next presentation: Examination part 1: Eyes, heart, hips and testes

NIPE eLearning package: http://cpd.screening.nhs.uk/nipe-elearning Further Information NIPE eLearning package: http://cpd.screening.nhs.uk/nipe-elearning Briefly covers newborn and infant examinations