By Bernard Valman, Roslyn Thomas
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Extra resources for ABC of the First Year, 6th Edition (ABC Series)
17 Sites for insertion of lancet. 18 Screening blood card. 19 Talking to parents. 20 Position for sleeping. For example, if the probable diagnosis is ventricular septal defect, it is not necessary to explain that there is a remote possibility of multiple cardiac defects. After a difficult forceps delivery, it is better to say that most babies develop normally rather than say they may be slightly disabled. An unnecessarily pessimistic prognosis based on out-of-date information may alter a mother’s attitude towards her baby and impair her attachment to him or her.
Early examination of the heart and hips will reveal physiological cardiac bruits and ligamentous clicks which disappear within hours of birth. They are of no clinical significance, but generate anxiety for the parents and the infant will require repeat examination the next day. The obstetric notes should be checked to determine whether the infant has been at special risk – for example, from maternal ill-health or a difficult delivery. A systematic approach should be used so that abnormalities are not missed.
Gastroschisis is a more extensive midline abdominal defect which is often associated with chromosomal anomalies such as trisomy 13 or 18. Surgical closure of the defect is indicated if the infant does not have other life-threatening symptoms. 6). The diagnosis of oesophageal atresia is confirmed by attempting to pass a tube down the oesophagus. The tube should have a relatively wide lumen (FG 10), must be stiff enough to prevent coiling in the upper oesophageal pouch, and should have a radio-opaque line so that the position can be checked by a chest radiograph.
ABC of the First Year, 6th Edition (ABC Series) by Bernard Valman, Roslyn Thomas