The Toxic Neonate


How do you manage the crashing neonate?

An interview with Dr. Tim Horeczko about how to recognize and manage the crashing neonate. Topics include:

  • The pediatric assessment triangle
  • Managing hypoglycemia in a pediatric resuscitation
  • IV fluid management
  • Cyanotic Heart Disease
  • Inborn errors of metabolism
  • An appearance by Borat

Additional Resources:


  1. Pingback: Managing fever in kids -

  2. Neil Perera

    can you tell me how we can use 102.2 as the fever cut off for 2-3 month old infant? If there is good data; I would love it!

    1. Rob Orman

      From Andy Sloas……
      No great data, I thought I said that in the show…it’s my favorite thing to say about the Peds lit.

      It’s what we did in clinical practice at TCH as a practice pattern and what I do as well, but no great data. It’s just like moving the tap thing down to 6 wks, or modifying the Rochester criteria. All that stuff makes sense and based on the prevalence of SBI I quoted, it’s what I do, but like everything else in Peds…, Double D level evidence….

      Here are the sources for 3 months and 102.2:

      Baraff LJ, Bass JW, Fleisher GR, Klein JO, McCracken

      GH Jr, Powell KR, et al. Practice guideline for the
      management of infants and children 0 to 36 months
      of age with fever without source. Agency for Health
      Care Policy and Research [Published correction appears
      in Ann Emerg Med 1993;22:1490]. Ann Emerg Med

      American College of Emergency Physicians Clinical
      Policies Committee, American College of Emergency
      Physicians Clinical Policies Subcommittee on Pediatric
      Fever. Clinical policy for children younger than three
      years presenting to the emergency department with
      fever. Ann Emerg Med 2003;42:530-45.

      Baraff LJ. Management of fever without source in
      infants and children. Ann Emerg Med 2000;36:602-14.

      The index article, which was pre-prevnar and HiB that says 2mos:
      Dagan R, Sofer S, Phillip M, Shachak E. Ambulatory care of febrile infants
      younger than 2 months of age classified as being at low risk for having serious
      bacterial infections. J Pediatr. 1988 Mar;112(3):355-60. PubMed PMID: 3346773.

  3. Pingback: Resuscitation of the crashing infant – First10EM

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