Treating a critically ill infant can be terrifying for an emergency physician, said Richard M. Cantor, MD, FACEP, professor of emergency medicine and pediatrics and director of the pediatric emergency department at Upstate Medical University, State University of New York, in Syracuse.
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“They don’t give you many clues, and they can’t give you any history. They don’t have a lot of measurable behavior to ask parents about,” Dr. Cantor said.
In Dr. Cantor’s session, “The First 30 Minutes: Initial Management of the Critically Ill Infant,” he will aim to provide some help to physicians.
“The session is essentially a how-to manual to give someone, in the midst of their panic, an organized approach,” he said.
One point he will cover is the importance of listening to parents. “Even younger or uninformed parents know when something is wrong with their baby,” he said.
Another point to consider with critically ill infants is that they do not have any physiologic reserves when they become ill. “They don’t fight infection well, they become dehydrated quickly, and if they are born with a congenital problem such as a malformation, this is when it’ll show its true colors,” Dr. Cantor said.
For example, vomiting in the young infant may be something benign or may be the result of a malformation in the gastrointestinal track. Or a cough could be secondary to an airway malformation. This gives the emergency physician a little more to think about when making a diagnosis.
“What’s frustrating as the clinician is that you can’t fix the problem at the bedside. You have to get help immediately,” he said.
The good news, however, is that once infants get the appropriate care and stabilization, they often will stabilize, Dr. Cantor said. Fortunately, most congenital defects that are truly life-threatening will usually show up in the first two weeks after birth.
Dr. Cantor’s session also will discuss diagnosis and treatment of shock, infections, cyanosis, heart disease, and seizures.
Vanessa Caceres is a freelance medical writer based in Florida.
The First 30 Minutes: Initial Management of the Critically Ill Infant
Tuesday, Oct. 27
Room 153 ABC