[The Dutch College of General Practitioners' practice guidelines, "Examination of the neonate": response from the perspective of pediatrics].
The practice guideline on routine neonatal examination of the Dutch College of General Practitioners describes the examination of the newborn directly after birth, whether at home or in the hospital. It is proposed that examination be limited to inspection, without auscultation and palpation. If conducted strictly according to the guidelines given, this may be sufficient. However, auscultation of the heart is the most reliable way to determine the heart rate. Including auscultation and palpation in the routine examination after birth would contribute to the experience of general practitioners with these techniques in babies. This is of importance, since general practitioners are the first to be consulted in case of any health problems in this patient category. Previously, it was recommended that the general practitioner visit mother and child on the third, fourth or fifth day after delivery and examine the baby. In the new standard, this second examination is considered to be redundant, based on data in the literature. However, it remains the duty of the general practitioner to inform the parents about (non-specific) early signs of disease in newborns. Furthermore, the threshold for consultation of the general practitioner should be low for the early diagnosis and management of serious conditions, such as septicaemia or congenital heart disease.
Kollée
L A A
LA
Universitair medisch Centrum St Radboud, afd. Kindergeneeskunde, Postbus 9101, 6500 HB Nijmegen. l.kollee@ckskg.azn.nl
D005194:Family Practice; D006339:Heart Rate; D006801:Humans; D007231:Infant, Newborn; D015997:Neonatal Screening / Q000592:standards*; D009426:Netherlands; D010808:Physical Examination; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'