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Question: Neonatal

A 36-week infant is born precipitously NSVD to a 17yo G2P1 mother in the ED after the mother presented with the chief complaint of intermittent abdominal pain. Apgars are 8 and 9 at 1 and 5 minutes, with -1 for color at both times and -1 for reflex irritability at 1 minute. The O2 sat in the left upper extremity is 82% at 5 minutes. The baby is crying intermittently, is not pale or plethoric, and is in no respiratory distress. Lung sounds are equal and clear bilaterally, and cardiac exam is normal. The next best intervention is:

A. Intubate and mechanically ventilate

B. Suction and apply 100% O2

C. Suction and apply nasal canula O2 at 5 L/min

D. Transilluminate the chest to r/o pneumothorax

E. Continue to observe the infant

Check back in a few days for my answer and others’ comments

Also, if you’re interested in the Peds ID Question of the Week, you can find it here


pemsou5_wp • May 30, 2017

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  1. Kelly June 5, 2017 - 11:13 pm Reply

    E. Continue to observe the infant. Targeted preductal O2 sat after birth at 5 minutes is 80-85%, so the infant’s O2 sat is within the expected range. To review neonatal resuscitation and the expected O2 sat by minutes post-birth, see

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