6 hours / Neonate

1
CASE 1 Paedatric Emergency
6 hours / Neonate Born to a mother from rural
background No homoeopathic orientation
Call received at 1 am in the night for
stabilizing a neonate having respiratory
distress and convulsions immediately after birth
following difficult labor.
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CASE 1 Paedatric Emergency
A/F BIRTH TRAUMA BIRTH ASPHYXIA
PRESENTATION NO AURA ICTAL PHASE- BITING LIPS
TWITCHING FACE? DISTORTION FACE
HEAD ROLLING TO SIDES
TONIC CLONIC MOVEMENTS OF EXTREMITIES
CLENCHED FIST
POST ICTAL PROSTRATION
PUPILS DILATED
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CASE 1 Paedatric Emergency
Examination
General condition Poor Peripheral cyanosis
Heart rate 160 / minute Heart sounds
Normal Respiratory Rate 60/ minute
Conducted sounds and crepitation
CNS Generalized tonic - colonic movements of
upper and lower extremities, facial distortion
and frothing at mouth Hyper tonic spasm
Plantars extensor
Investigation Serum Glucose Normal Serum
Calcium Normal
4
STRUCTURE
TIME
FORM
FUNCTION
5
CASE 1 Paedatric Emergency
Brain Oedma and Hypoxia
6 hours
Cerebral irritation
A/F Birth Trauma and asphyxia Convulsions
Status epilepticus Facial distortion
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CASE 1 Paedatric Emergency
TOTALITY
A/F Cerebral Concussion Facial
distortion Pupils dilated Head turning
sides Prostration
CICUTA
SUSCEPTIBILITY ASSESSMENT
Pace of disease Rapid Pathology Acute
Oedma of brain Vitality Compromised
Characteristic Present Correspondence
Adequate
200 C frequently 1 hrly---4 hrly
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CASE 1 Paedatric Emergency
Ancillary measures
Continuous Oxygen Radiant warmer Intermittent
Naso Oral Suction Naso gastric Intubations
Intra Venous fluids
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FOLLOW UP
CASE 1 Paedatric Emergency
CHILD RELAXED 1st hr. Convulsions better in
Freq. 2nd hr. Convulsions better 50 5th
hr. Convulsions better 75 Only facial
twitching Child appeared PEACEFUL 8th
hr. Convulsions NIL 24th hr. CHILD ACTIVE
9
Conclusion

• Long term evaluation and management of this child
  would only require constitutional treatment.
• The possible long-term brain damage was
  contained and cured within 24 hours, quite a feat
  considering that this child may not have survived
  at all!