Neonatal surgical emergencies: stabilization and management

The transitional period following birth can be complicated by the presence of congenital anomalies requiring emergent surgical management. Newborns with congenital diaphragmatic hernia require immediate intubation and gastric decompression to minimize gastric distention, as well as cautious ventilation to avoid pneumothorax. Newborns with omphalocele and gastroschisis are at risk for bacterial contamination, as well as heat and evaporative losses from exposed viscera. These newborns benefit from the use of a protective bowel bag. Newborns with meningomyelocele require meticulous care to avoid infection and trauma to exposed portions of the spinal cord. An illustrated protocol provides guidance in the initial stabilization of these defects. Nurses providing family-centered care must be knowledgeable about congenital anomalies presenting at birth so they can properly stabilize these newborns and provide accurate information to families.