Suspected early-onset neonatal sepsis — emergency management station

Emergency management station for suspected EOS in a term infant with the full risk tier. Tests parallel resuscitation, the empirical antibiotic regimen with doses, the 48-hour stewardship checkpoint, and closed-loop communication with the neonatal team and the mother. Includes assessor key and marking domains.

Prompt

A term infant is 3 hours old. The mother is GBS-positive, received only 2 hours of intrapartum benzylpenicillin, with ROM 26 hours. Her intrapartum temperature peaked at 38.7 degrees. The baby is grunting, RR 72, HR 178, capillary refill 4 seconds, temperature 36.2 degrees. You are the obstetric registrar; the neonatal registrar is 8 minutes away.

Station brief

Format. Emergency management station, approximately 12 minutes. You are the obstetric registrar covering the postnatal ward. A midwife and a ward nurse are with you; the neonatal registrar is 8 minutes away and has been called. The assessor will run the clock and feed you new observations. ^[1]

Candidate instruction. Lead the immediate management of suspected early-onset neonatal sepsis. Verbalise your actions, your drug orders with doses, your investigation sequence, and your communication with the neonatal team and the mother. ^[1]^[2]

References5Show

[1]Polin RA; Committee on Fetus and Newborn Management of neonates with suspected or proven early-onset bacterial sepsis Pediatrics, 2012.PMID 22547779
[2]Flannery DD, Puopolo KM Neonatal Early-Onset Sepsis Pediatr Clin North Am, 2022.PMID 36316253
[3]Puopolo KM, Benitz WE, Zaoutis TE Management of Neonates Born at ≥35 0/7 Weeks' Gestation With Suspected or Proven Early-Onset Bacterial Sepsis Pediatrics, 2018.PMID 30455342
[4]Weiss SL, Peters MJ, Alhazzani W, et al. Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children Intensive Care Med, 2020.PMID 32032273
[5]American College of Obstetricians and Gynecologists Committee on Obstetric Practice Prevention of Group B Streptococcal Early-Onset Disease in Newborns: ACOG Committee Opinion, Number 797 Obstet Gynecol, 2020.PMID 31977795

Suspected early-onset neonatal sepsis — emergency management station

Station brief

References5Show

[1]Polin RA; Committee on Fetus and Newborn Management of neonates with suspected or proven early-onset bacterial sepsis Pediatrics, 2012.PMID 22547779
[2]Flannery DD, Puopolo KM Neonatal Early-Onset Sepsis Pediatr Clin North Am, 2022.PMID 36316253
[3]Puopolo KM, Benitz WE, Zaoutis TE Management of Neonates Born at ≥35 0/7 Weeks' Gestation With Suspected or Proven Early-Onset Bacterial Sepsis Pediatrics, 2018.PMID 30455342
[4]Weiss SL, Peters MJ, Alhazzani W, et al. Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children Intensive Care Med, 2020.PMID 32032273
[5]American College of Obstetricians and Gynecologists Committee on Obstetric Practice Prevention of Group B Streptococcal Early-Onset Disease in Newborns: ACOG Committee Opinion, Number 797 Obstet Gynecol, 2020.PMID 31977795