Good evening everyone! I won’t ask how was the exam as i know standard of Aiims is quite good so you never know where exactly you are lying. As I said yesterday, it’s serendipity. Some of you might be feeling quite low,and on the other hand perhaps, some might be having high shoulders. Irrespective of the case,the point is not what the exact question was or what the options were,if you just want to have a general discussion about the topic i am happy to elaborate here. You never know you might find your answer in the discussion itself. 
So if that is the case you all are welcome to post the questions/topics here.
Best wishes!
Dr Manoj Malhotra
MBBS (MAMC) MD pediatrics (LHMC)
Of course i can. Silverman scoring system is devised to grade the severity of respiratory distress in a preterm baby. It has 5 components: Upper chest retractions, lower chest retractions, xiphoid retractions, nasal flaring and grunting. Each aspect is scored on the scale of 0,1 and 2,less severe to most severe in that order. Score of 7 or more implies impending respiratory failure and warrants advance airway like endotracheal intubation. I hope this was helpful.
I was informed that there was a question on neonatal resuscitation too. This I posted in some other group a month ago. See and let me know whether you get your answer or not.
Neonatal resuscitation is quite different in many ways as compared to adult and children’s resuscitation. The guidelines which we usually generally follows are American 2015 NRP guidelines, which stands for neonatal resuscitation program. Nowadays we are having our own Indian version of it,which is called Indian NRP.
Few salient features of the latest guidelines are:
Special status of the babies who are borne with a meconium stained liquor has been abolished. It means that like all other babies, they also receive bag and mask ventilation first,instead of endotracheal suction which used to be the earlier practice.
Nowadays we talk about the 'Golden minute ',which means first minute of life.All the initial basic steps should be performed within this minute. This basic steps means: Receiving the baby in a prewarmed linen,drying, positioning and placing under the radiant warmer.
At this stage,we should see whether the baby is vigorous or not. The criteria of a vigorous baby are- HR>100,good spontaneous respiratory efforts and good muscle tone,and not the color. If any criteria is missing, baby is called non vigorous.
In such cases, next steps would be oro nasal suction (in that order),tactile stimulation followed by bag and mask ventilation. Every step is followed by a reassessment, and for bag and mask ventilation we have to assess after every 30 seconds.
Now,you need to remember 2 values here,60 and 100. If hr is between 60 and 100,continue bag and mask ventilation if there’s no or inadequate respiratory efforts. If at any point, if hr goes below 60,starts CPR in ratio of 3:1 which means 120 events in a minute. At this time, consider advance airway.
This was very briefly about resuscitation. It is a very big topic as you can see,I haven’t covered all the things but it should suffice perhaps for your entrance exams.
Best wishes !
Dr Manoj Malhotra
MBBS (MAMC) MD pediatrics (LHMC)