Emergency Newborn Care

The timing of this publication on emergency obstetrics and pediatrics was very serendipitous for me. It’s been about three years since I attended my last field delivery, and while I wasn’t overly nervous about my OB and neonatal skills, this was a good review.

Scott L. DeBoer, the author of Emergency Newborn Care: The First Moments of Life, has distilled an enormous amount of material into a relatively short text, and managed to keep it simple, easy to follow and even enjoyable to read—qualities not found in most medical texts. His focus on basics—for instance, the use of the “newborn mantra”—makes initial assessment and subsequent treatment of newborns intuitive and easy to remember. De-emphasizing memorization of such things as drug dosages and tube sizes also makes for a more appropriate focus on initial newborn care.

The section that covers endotracheal tube placement provides a good rationale for determining when to intubate and offers simple rules for determining tube size, independent of adjunctive systems such as those made by Broselow-Luten and Pedi-Wheel, while recommending their use if available. Likewise, devoting a section to the secure taping of the tube after placement covers an often-overlooked but essential part of airway control. There is also an appendix on sedation for intubation located in the back of the book.

The one minor complaint I have about this section is the small size of the accompanying illustrations and photographs of newborn airways; it’s hard to determine the actual structures and landmarks for intubation. Otherwise, it’s an excellent chapter on airway control.

The chapter on essential newborn medications is also simple to understand, with an excellent rationale accompanying each drug section.

The final chapter acts as an encompassing summation of the preceding chapters and an effective lead-in to a series of appendices providing one scenario in each of the following environments: ED, EMS and L&D. The EMS scenario, especially, presents a powerful call that will challenge all your skills. I intend to make it a part of our next training rotation at the San Francisco Fire Department.

Emergency Newborn Care is an excellent book, appropriate to anyone who may have to deal with newborn care sometime in his or her career. I have personally recommended that this book be added to our curriculum for new paramedic trainees, as well as salty old dogs like myself.