Application of clinical score in sick neonates received at our emergency unit and its impact on the outcome of the neonate and to compare the effect of trained personnel accompanying the child.
India contributes to one fourth of neonatal mortality .This study objective
is to device and apply a score in sick neonates received in our emergency ward
and its impact on the outcome of the neonate and to compare the effect of
trained personnel accompanying the child.
METHODS:
A prospective descriptive study was conducted in our institute during the
period of 1.7.2014-15.9.2014 in the department of newborn emergency room
and neonatal wards of institute of child health .The neonates fulfilling the
inclusion criteria were included in the study .Demographic details pertaining to
the mother and baby ,transport details, personnel accompanying, referral
indications, pre hospital therapy were collected on admission.On arrival in the
emergency room vital parameters were recorded,stabilised and admitted in the
ward. These neonates were followed up till discharge or death.
RESULTS:
Sepsis(29.4%),asphyxia(16%),prematurity(11%) were the common
indications for referral.39.4% of neonates were transported by dedicated 108
Neonatal ambulances followed by own modes of transport.60% of neonates
were accompanied by the trained personnel.14.6% succumb to the illness
among the referred neonates.Among the parameters recorded on arrival Heart
rate,Perfusion,Capillary blood glucose,temperature and Apgar at 5 minutes were
considered significant.A score was devised using these parameters,cut off of 3
was obtained by ROC curve with high mortality when the score is >3 with
sensitivity88.2% and specificity 82.8%.Neonates who were accompanied by
trained personnel had better outcome than the neonates brought unaccompanied.
CONCLUSION:
The score devised by our study is simple and effective in predicting
mortality and highlights the need for aggressive management on arrival for
better outcome.Neonates accompanied by trained personnel had a better
outcome
