Presentations
- Antenatally diagnosed conditions
- Billious vomiting
- Cardiac murmurs
- Collapsed neonate
- Cyanosis
- Dysmorphic features
- Floppy infant
- Hypoglycaemia
- Hypothermia
- Jaundice
- Large for gestational age
- Neonatal resuscitation
- Poor feeding
- Preterm neonates
- Respiratory distress
- Seizures
- Slow growth
- Small for gestational age
- Vomiting
Conditions
-
Air leak syndromes:
- pneumomediastinum
- pneumothorax
- Anaemia
- Apnoea
- Birth trauma:
- brachial plexus palsy
- cephalhaematoma
- clavicular fracture
- subgaleal haemorrhage
- Bronchopulmonary dysplasia
- Congenital anomalies of the kidney and urinary tract
- Congenital heart disease, including duct-dependent circulation
- Congenital malformations:
- cleft lip or palate
- digit / limb abnormalities
- Pierre Robin sequence
- sacral dimples
- single umbilical artery
- Congenital pneumonia
- Developmental dysplasia of the hips
- Electrolyte abnormalities
- Gastro-oesophegeal reflux
- Group B strep sepsis screening and management
- Head moulding
- Hypoglycaemia
- Hypoxic ischaemic encephalopathy
- Infant of diabetic mother
- Intracranial or intraventricular haemorrhage
- Intrauterine growth restriction
- Lung disease, chronic
- Meconium aspiration syndrome
- Meningitis and encephalitis
- Nasolacrimal duct obstruction
- Necrotising enterocolitis
- Neonatal abstinence syndrome
- Neonatal asphyxia
- Neonatal infection
- Persistent pulmonary hypertension
- Plagiocephaly
- Polycythemia
- Respiratory distress syndrome
- Retinopathy of prematurity
- Sepsis
- Shock
- Skin conditions
- Small for gestational age
- Transient tachypnoea of the newborn
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a relevant clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigation
- consider the impact of illness and disease on patients and families, and their quality of life
Manage
- provide evidence-based management
- for less common or more complex presentations and conditions the trainee must also seek expert opinions
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Conditions
- Ambiguous genitalia
- Choanal atresia
- Chromosomal and genetic conditions
- Congenital adrenal hyperplasia
- Congenital and perinatal infections
- Congenital brain abnormalities
- Congenital diaphragmatic hernia
- Congenital eye abnormalities
- Congenital lung abnormalities
- Congenital skin disorders, such as ichthyosis and epidermolysis
- Disseminated intravascular coagulation (DIC)
- Extreme prematurity
- G6PD deficiency
- Gastrointestinal emergencies
- Haematological conditions:
- acute bleeding disorders:
- lymphopenia
- neutropenia
- thrombocytopenia
- vitamin K-deficient bleeding
- haemolytic disease of the newborn
- Hereditary spherocytosis
- Herpes simplex virus – approach to infants at risk or with suspected infection
- Hyperthyrodism
- Hypothyroidism
- Larygneal lesions
- Metabolic disorders
- Neonatal encephalopathy
- Neural tube defect
- Perinatal stroke
- Periventricular leukomalacia
- Pulmonary interstitial emphysema
- Respiratory failure
- Stridor
- Supraventricular tachycardia
Surgical problems in the neonate
- Abdominal wall defects
- Atresia:
- anal
- duodenal
- oesophageal
- Hirschprung disease
- Hypospadias
- Inguinal hernia
- Intestinal malrotation, with or without volvulus
- Meconium ileus
- Trachea-oesophageal fistula
- Undescended testes
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a relevant clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigation
- consider the impact of illness and disease on patients and families, and their quality of life
Manage
- provide evidence-based management
- for less common or more complex presentations and conditions the trainee must also seek expert opinions
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
- Anatomy, neurodevelopment, and physiology aspects of feeding and gut maturation in term and pre-term infants
- Drug metabolism in the neonate and breastfeeding mother, and appropriate and safe prescribing
- Effects of intrauterine and perinatal events on outcome
- Pathophysiology of common and uncommon neonatal conditions
- Physiology of extra-uterine adaptation, including initiation of feeding, and changes to cardiac and respiratory physiology
Clinical assessment tools
- Neonatal growth charts (Fenton)
- Newborn hearing screening
- Postnatal assessment of gestestional age (Ballard / Dubowitz)
Investigations
-
Blood tests:
- bacterial and viral PCR
- biochemistry
- blood gas
- endocrinological
- genetic investigations
- haematological
- inflammatory markers
- metabolic screening tests
- microscopy:
- culture and antimicrobial sensitivity
- newborn screening
-
Cardiac studies:
- echocardiography
- electrocardiography (ECG)
- Electroencephalography (EEG)
-
Other pathology:
-
cerebral spinal fluid microscopy:
- culture and antimicrobial sensitivity
- swabs from sterile and non-sterile sites
-
urine microscopy:
- biochemistry
- culture and antimicrobial sensitivity
- metabolic screening
- viral PCR
-
Radiology:
- MRI
- plain x-rays
- ultrasound
- upper gastrointestinal contrast study
Procedures
-
Awareness of role of adjuncts to diagnostic assessment and procedures, such as:
- point of care ultrasound (POCUS)
- transcutaneous bilirubinometer
- transilluminator
-
Intramuscular injections:
- vaccinations
- vitamin K injection
- Intubation
- Lumbar puncture
- Needle thoracostomy and intercostal drain insertion
- Nasogastric (N-G) tube placement
-
Peripheral intravenous (IV) access, including knowledge of:
- mid lines
- peripherally inserted central catheters (PICC)
- Suprapubic aspirate
- Surfactant administration
- Transfusion of blood and blood products
- Umbilical venous and arterial catheterisation
- Urinary catheter insertion
- Administration of maternal medications such as magnesium sulfate, steroids, and tocolytics for prevention of premature birth, prevention of perinatal morbidity, and neuroprotection
- Antenatal screening
-
Antenatally diagnosed conditions, such as:
- cerebral ventricular dilatation
- choroid plexus cysts
- congenital heart disease
- dilated kidney system
- Breastfeeding difficulties and support
-
Congenital conditions associated with maternal conditions, such as:
- maternal infections
- maternal medical diseases
- maternal substance use / misuse
- teratogens
- Continuous positive airway pressure (CPAP) and humidified high-flow oxygenation
- Developmental care for neonates
- Early intervention services
-
Extreme prematurity – decision making, along with obsteric collegues, regarding:
- immediate care of the neonate
- limits of viability
- managing labour
- Feeding difficulties
- Growth patterns in newborn period
- Immunisation of term and preterm infants
- Implications and considerations in the redirection of care and palliative care
- Implications of congenital abnormalities for continuation of pregnancy and method of delivery
- Implications of congenital abnormalities for development, physical, and psychological function during childhood and adolescence
- Implications of congenital abnormalities for genetic counselling
- Infant care, feeding, and sleep
- Infant caregiver relationship
- Local resources available to ensure monitoring of growth and development in the newborn
- Manual and mechanical ventilation, including bag mask and T-piece
- Multiple pregnancies and complications
- Neonatal fluid management, including intravenous fluid prescription
- Neonatal resuscitation
- Neurodevelopmental outcomes and follow-up
- Normal growth and development in neonates
- Normal neurodevelopmental milestones in preterm infants
-
Nutritional requirements of term and preterm infants:
- enteral feeding and parenteral nutrition
- Parental counselling
- Perinatal epidemiology
- Postnatal depression
-
Preterm neonate complications, such as:
- anaemia
- chronic neonatal lung disease
- electrolyte disturbances
- intraventricular haemorrhage
- long-term neurodevelopmental disability
- metabolic bone disease
- necrotising enterocolitis and spontaneous intestinal perforation
- nosocomial infection
- patent ductus arteriosus
- retinopathy of prematurity
- Prevention of perinatal mortality and low birth weight
- Principles of stabilisation and management of neonate prior to and during transport
- Procedural pain management, including sucrose and non-pharmacological supports
- Risk factors for neonatal sepsis and neonatal sepsis calculators
- Transport and retrieval issues
- Transport and retrieval services
- Vitamin, probiotic, and mineral supplementation and fortification options in premature infants
