154 6 CHAPTER 6 7. Glucose assessment 1 hour pp, thereafter 2 times a day before feeding (about 4 and 7 hours pp): 4 8. Glucose assessment 1, 3, 6 and 12 hours pp: 1 9. Glucose assessment 1, 3, 12 and 24 hours pp: 1 10. Glucose assessment 1, 3, 6, 9 and 24 hours pp: 2 11. Glucose assessment 1, 3, 6, 12, 18 and 24 hours pp: 1 12. Glucose assessment 1, 3, 6, 12 and 24 hours pp, and body length and skull circumference: 1 13. Glucose assessment 1, 3, 6, 12 and 24 hours pp, and physical assessment, observation feeding and temperature: 1 14. Glucose assessment 1, 3, 6, 12 and 24 hours pp, and physical assessment, observation feeding, temperature and color: 1 15. Glucose assessment 1, 3, 6, 12 and 24 hours pp, and physical assessment, observation breathing, circulation, feeding, temperature and color, and blood values, and ultrasound scan cerebrum: 1 16. Glucose assessment 1 and 4 hours pp: 1 17. Glucose assessment 1, 4 and 7 hours pp: 4 18. Glucose assessment 1, 4, 7, 16 and 24 hours pp: 1 19. Glucose assessment 1, 4 and 7 hours pp, and temperature assessment every 3 hours, and daily weight, and heartrate and breathing rate: 1 20. Glucose assessment 1, 4, 7, 12 and 24 hours pp, and breathing rate every 3 hours and temperature and color: 2 21. Glucose assessment 3, 6, 9 and 12 hours pp, and complete blood work and skull circumference: 1 22. Glucose assessment 3, 6, 12, 18 and 24 hours pp: 1 23. Glucose assessment 1 or 2 hours pp after first feeding, and 3, 6, 12 and 24 hours pp before feeding, and skull circumference, and daily weight assessment, and physical assessment: 1 24. Daily weight assessment: 2 - Referred to a different document: 10 - Not mentioned: 23 7. First glucose assessment <2.6 mmol/l and clinical symptoms, or <1.6 mmol/l without clinical symptoms: 1 8. Glucose <2.6 mmol/l <4 hours pp: 1 9. Glucose 2.6 mmol/l or 3 mmol/l >3 days: 3 10. Glucose <2.6 mmol/l or <1.5 mmol/l without clinical symptoms 0-3 hours pp, or <2.6 mmol/l 3-34 hours pp, or <3 mmol/l >24 hours pp: 1 11. Cut-off value glucose not mentioned, cutoff value head circumference <2.3th percentile : 1 12. For glucose cut-off values referred to a different document, cut-off value head circumference <-2 SD: 1 - Referred to a different document: 15 - Not mentioned: 32 7. Supplementary feeding and upscaling with glucose infusion: 8 8. Supplementary feeding and upscaling with glucose gel and glucose infusion: 1 9. Primary infusion: 1 - Referred to a different document: 14 - Not mentioned: 30 6. Good intake, weight loss <5%, further growth expected, weight >2000 g, last 2 glucose values >2.6 mmol/l, and stable temperature: 1 7. Good intake, weight loss <5%, further growth expected, weight >2000 g and last 2 glucose values >2.6 mmol/l: 1 8. After 3 days of observation: 1 9. Weight >2 kg: 3 10. Stable weight: 1 11. After 48-72 hours pp: 1 - Unclear: 6 - Not mentioned: 45 MSAF Obstetric 33 1. Assessment: 1 2. Physical assessment: 1 3. Physical assessment and no minimal duration of observation: 1 4. Observation respiratory problems: 1 5. Observation ≥8 hours pp: 6 6. Assessment respiratory problems regularly ≥8 hours pp: 5 7. Observation breathing every 3 hours ≥8 hours pp: 1 8. Observation breathing and temperature every 2 hours ≥8 hours pp: 1 9. Observation breathing, temperature, color, alertness, and psychical examinations ≥8 hours pp: 2 10. Observation breathing, temperature and heartrate ≥8 hours pp: 1 11. Observation breathing 8-12 hours pp: 1 12. Observation breathing every 3 hours 8-24 hours pp: 1 13. Observation breathing, grunting, chest retractions, signs of infection, heartrate, feeding, nauseousness, temperature and color ≥12 hours pp: 1 1. When in doubt or abnormal observations: 1 2. Breathing rate >60/min, temperature <36.5°Cand >37.5°C: 1 - Referred to a different document: 2 - Unclear: 1 - Not mentioned: 28 1. The pediatrician decides about the necessity of long-term observation or admission: 2 2. When in doubt 24 hours observation, or consider admission at the neonatal ward in case of abnormal observations: 1 - Referred to a different document: 2 - Not mentioned: 28 1. Normal physical assessment, no minimum admission time: 1 2. Good clinical condition, after pediatrician’s assessment: 1 3. Breathing rate <60/min, temperature >36.5°C and <37.5°C, normal physical assessment and maternity care assistant present at home: 1 4. After 8 hours observation: 12 5. After 8 hours in absence of respiratory problems: 3 6. After 8 hours in consultation with the pediatrician: 1 7. After 8 hours observation and pediatrician’s assessment: 1 8. After 8-12 hours: 1 12. Glucose <2.6 mmol/l <3 hours pp or no clinical symptoms and glucose <1.5 mmol/l, 3 glucose <2.6 mmol/ l-24 hours pp, glucose <3.0 mmol/l >24 hours pp: 1 - Unclear: 10 - Not mentioned: 11 SGA Obstetric 47 1. Glucose assessments: 2 2. Glucose assessment during 24 hours pp: 1 3. Glucose assessments and temperature assessment: 1 4. Glucose assessment for which referred to a different document, and skull circumference: 1 5. Glucose assessment for which referred to a different document, and observation and skull circumference: 1 6. Glucose assessment 30 minutes after first feeding, first feeding <1 hour pp, and glucose assessment 3, 6, 12 and 24 hours pp before feeding: 1 7. Glucose assessment 30 minutes after first feeding, first feeding <1 hour pp, otherwise glucose assessment one hour pp and thereafter 3, 6, 12 and 24 hours pp before feeding: 3 8. Glucose assessment 30 minutes after first feeding, first feeding <1 hour pp, and glucose assessment 3, 6, 12 and 24 hours pp before feeding, and physical assessment and VBO: 1 9. Glucose assessment within 1 hour pp, and 2, 4, 12 and 24 hours pp before feeding: 1 10. Glucose assessment 1,3 and 6 hours pp: 1 11. Glucose assessment 1, 3, 6, 9 and 24 hours pp, and skull circumference, and CMV assessment if necessary: 1 12. Glucose assessment 1, 4 and 7 hours pp: 2 13. Glucose assessment 1, 4 and 7 hours pp and CMV assessment in urine: 1 14. Glucose assessment 3, 6, 12, 18 and 24 hours pp: 1 15. Glucose assessment 1, 3, 6 and 12 hours pp: 1 16. Glucose assessment for which referred to a different document, temperature assessment every 3 hours, assessment of heartrate and breathing rate, observation of feeding, defecation tone and umbilical cord, and skull circumference two days pp: 1 - Referred to a different document: 8 - Unclear: 1 - Not mentioned: 18 1. Glucose <1.9 mmol/l <1 hour pp, <2.2 mmol/l 2-24 hours pp or <2.6 mmol/l >24 hours pp: 1 2. Glucose <2 mmol/l <4 hours pp, thereafter <2.5 mmol/l: 2 3. Glucose <2 mmol/l <6 hours pp, or <2.7 mmol/l ≥6 hours pp: 1 4. Glucose <2.6 mmol/l: 2 5. For glucose cut-off values referred to a different document, and breathing rate 3555/min, and heartrate 155-200/min, and temperature 36.5-37.5°C: 1 - Referred to a different document: 14 - Unclear: 4 - Not mentioned: 22 1. Routine supplementary feeding: 6 2. Supplementary feeding and upscaling with glucose infusion: 4 3. Supplementary feeding and upscaling with glucose gel and glucose infusion: 2 4. Enteral feeding every 3 hours if possible, if liquid intake becomes too much start with glucose 15%, 20% etc.: 2 - Referred to a different document: 12 - Not mentioned: 21 1. After a least 24 hours pp: 2 2. After several glucose values >2.6 mmol/l at serval and infusion proofs unnecessary and pediatrician’s permission: 1 3. After 3 glucose values >2.6 mmol/l: 1 4. After at least 48 hours: 1 - Unclear: 2 - Not mentioned: 40 Neonatal 68 1. Glucose assessments: 3 2. Glucose assessments and ultrasound scan cerebrum and hearing screening: 1 3. Glucose assessment, and physical assessment, and complete blood work: 1 4. Glucose assessment for which referred to a different document, and observation and skull circumference: 1 5. Glucose assessment for which referred to a different document, and physical assessment, and CMV assessment if necessary: 1 6. Glucose assessment 30 minutes after first feeding, first feeding <1 hour pp, and glucose assessment 3, 6, 12 and 24 hours pp before feeding: 1 1. Glucose <1.8 mmol/l 1 hour pp, or <2.3 mmol/l ≥4 hours pp: 2 2. Glucose <1.9 mmol/l 1-3 hours pp, <2.2 mmol/l 3-24 hours pp, or <2.6 mmol/l and clinical symptoms: 2 3. First glucose assessment <1 hour pp <2 mmol/l, thereafter <2.6 mmol/l: 1 4. Glucose <2.2 mmol/l <4 hours pp, <3.5 mmol/l >4 hours pp or <3 mmol/l >24 hours pp: 2 5. Glucose ≤2.5 mmol/l and clinical symptoms or <1.5 mmol/l without clinical symptoms: 1 6. Glucose <2.6 mmol/l: 5 1. No routine supplementary feeding: 1 2. 8 feedings: 1 3. Feeding every three hours, if necessary consult pediatrician to agree on further policy: 1 4. Routine supplementary feeding: 7 5. 8 feedings either breast or bottle, breastfeeding always with supplementary feeding: 1 6. Feeding every 3 hours, supplementary feeding if necessary or admit sucrose: 3 1. 12 hours pp only after at least 3 normal glucose values of which 2 consecutive normal (>2 mmol/l 2 hours pp and thereafter 2.6 mmol/l): 1 2. After at least 24 hours pp: 4 3. After at least 24 hours pp, 2 glucose values ≥2.6, and ≥2 stable glucose: 1 4. Normal glucose values >4 hours of screening: 1 5. The last 2 glucose values >2.3 mmol/l: 2
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