Professional Documents
Culture Documents
Prof. S N Singh
Pediatrics
Learning Objectives
• Definition of ENC
• Components of ENC
• How to provide ENC
• Algorithm of neonatal resuscitation
• Prevention of Hypothermia in neonates
ENC: Definition
• Majority of babies born healthy and at term
• Care during first hours, days and weeks of life
determine whether they remain healthy
• Basic care to support survival and wellbeing
is called ENC
• It includes immediate care at birth, care
during the first day and up to 28 days
Neonatal Deaths
Neonatal deaths are a major contributing factor to U5
mortality in India
Under
five deaths
Neonatal
37% 50% deaths
World India
Source:
PFC 2007 & SRS
Major causes of U5 mortality
Neonatal
45% Measles Others, 6
4% Diarrhoea, 2
Malaria
1%
Neonatal
Others
8% Tetanus, 4
injuries
2% Congenital
HIV/AIDS anomaly, 4
1% Sepsis, 36
Pneum onia
Diarrhoea
19%
20% Small/Very
Small at birth,
21
Asphyxia, 23
Week 1 73.3%
Day U5
Day1 39.5% Child
deaths
2 6.7% Asphyxia
3 10.2% Prematurity
1st day 20%
4 5.6%
5 5.6% By 3rd
day
25%
6 2.7%
7 3.0%
Tetanus By 7th 37%
Sepsis / day
pneumonia
Week 2 13.8%
By 28th 50%
Week 3 8.7% day
Week 4 4.2%
Labored
Gasping/Apnea or No
30 sec breathing/Cy Evluation
HR<100 anosis
Yes
Yes
Insure open airway, O2,
Initiate PPV Monitoring, Consider B
60 sec using air/O2 shifting to SCNU
Initiate PPV
using air/O2
If Heart rate < 60 bpm and chest rising Baby breathing Post-
• Continue PPV, add 100% oxygen well and resuscitation
• Start chest compressions: 3:1 heart rate>100 care
bpm
C
If HR not detectable or <60bpm
Give Adrenaline
Where do babies go from delivery
room?
A) Refer if:
• Birth weight <1500 gms, <34 weeks
• Major congenital malformation
• Severe birth injury
• Respiratory distress
• PPV >1 minutes or needing chest
compression or drugs
B) Observational care: