Abstract

Visits to the ED by neonates can generate anxiety in both parents and ED staff. Many of the presenting complaints are unique to the neonatal population; understanding both common problems and true medical emergencies in this patient population is paramount.

The most common presenting complaints among neonates to one pediatric ED included jaundice, difficulty breathing, feeding problems, and irritability, while the most frequent diagnoses were normal physiology, jaundice, feeding problems, and “possible sepsis.”¹

While most neonatal emergencies are fairly benign, this trend may be changing. Because of earlier newborn discharges from hospitals and because of the lack of prenatal care in many populations, EDs are seeing an increase in newborn visits.² In one study of newborns who were discharged early, lowincome, Latino, and other non-English speaking families were least likely to have the recommended follow-up.3 In another study, the use of the pediatric ED by newborns less than 8 days of age increased from 2% to 31% because of early discharge policies.¹

With the increase in neonatal ED visits, emergency physicians must become more adept at identifying and managing critically ill neonates. This issue of Emergency Medicine Practice provides a structured approach to the critically ill neonate and serves as a companion piece to the October 2002 issue of Emergency Medicine Practice, “The Critically Ill Or Comatose Infant: An Organized Approach.”