Pediatric emergency medicine trisk 2487 2487
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KEY POINTS
Neonates may develop hemorrhagic shock from intracranial or
subgaleal bleeding.
Neonates are obligate nasal breathers until 6 weeks of life. Any nasal
obstruction can cause respiratory distress during this period.
RELATED CHAPTERS
Signs and Symptoms
Cyanosis: Chapter 21
Respiratory Distress: Chapter 71
Medical, Surgical, and Trauma Emergencies
ENT Emergencies: Chapter 118
Neurosurgical Emergencies: Chapter 122
Disorders of Head Size, Shape, and Symmetry
CLINICAL PEARLS AND PITFALLS
Overriding sutures are common in babies born via normal vaginal
delivery.
Neonates can herniate despite an open anterior fontanelle, even
without bulging of the anterior fontanelle, if the pathology is confined to
the posterior fossa.
Increase in head circumference accompanied by any sign of increased
intracranial pressure (bulging fontanelle and widened sutures) should
be investigated.
Neonates with hydrocephalus generally do not develop papilledema.
Subgaleal hemorrhage can be an acute life-threatening emergency
resulting in acute blood loss and shock. Vacuum extraction and
coagulopathy, including vitamin K deficiency, may be predisposing
factors.
Current Evidence
