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EARLY CLINICAL SIGNS OF DETERIORATION
IN NEWBORNS
Why Newborns are more susceptible
to illness
• Change over from Intra-uterine to extra-uterine
life
• Immature and slow responding Immune System
• Poor Skin barrier
• Umbilical Stump
• Poor Blood brain barrier
• Maternal History of GBS
• PROM more than 18 hours
• Maternal Fever
• Maternal UTI
• Chorioamnionitis
Infants at Risk
Careful observation and appropriate
action can save lives
• Proper training
• Confident finding will lead to successful treatment
• Identifying normal values at the earliest
Newborn Early Warning Score
Remember
ABC My Nursery Temperature !!
• Air way Signs
• Breathing Signs
• Cardiac Signs
• Metabolic Signs
• Neurologic Signs
• Temperature
Air way, Breathing Signs
• Apnea
• Tachypnea
• Grunting
• Shallow breathing
• Inter coastal, sub coastal or
Supra-sternal recession
Cardiac Signs
• Tachycardia
• Bradycardia
• Hypoxemia
• Hypotension
• Pallor
• Poor capillary perfusion
• Edema
Metabolic Signs
• Hypoglycemia
• Hyperglycemia
• Metabolic acidosis
• Jaundice
Neurologic Signs
• Lethargy
• Irritability
• Impairment of consciousness
• Hypotonia
• Buldging anterior fontanalle
• Seizure or any subtle movements
Temperature Instability
• Hyperthermia
• Hypothermia
Evaluation
• Know the Normal Values- most important!
• RR, HR, SPO2, Capillary Filling time, BP,
Temperature, Blood Sugar
References
• www.nhs.uk
• American Nurse Today
Journal 2012
• Medscape Article 2012
THANK YOU

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Early Signs of Deterioration in Newborn