Principles of Pediatric and Neonatal Emergencies
Principles of Pediatric and Neonatal Emergencies
4th Edition
Editor-in-Chief
Piyush Gupta MD FIAP FNNF FAMS
Professor and Head Department of Pediatrics University College of Medical Sciences and Guru Teg Bahadur Hospital
New Delhi, India
President-Elect, Indian Academy of Pediatrics 2020
Chief Academic Editors
Arvind Bagga MD FIAP FAMS FISN
Professor Division of Nephrology Department of Pediatrics All India Institute of Medical Sciences
New Delhi, India
Siddarth Ramji MD FNNF
Director-Professsor Department of Neonatology Maulana Azad Medical College and Associated Lok Nayak Hospital
New Delhi, India
Academic Editors
Krishan Chugh MD MNAMS FISCCM
Director and Head Department of Pediatrics and Pediatric Intensive Care Unit Fortis Memorial Research Institute
Gurugram, Haryana, India
Rakesh Lodha MD
Professor Department of Pediatrics All India Institute of Medical Sciences
New Delhi, India
Executive Editors
Pooja Dewan MD MNAMS FIAP
Professor Division of Hemato-Oncology Department of Pediatrics University College of Medical Sciences
New Delhi, India
Jaya Shankar Kaushik MD DNB DM
Associate Professor Department of Pediatrics Pandit Bhagwat Dayal Sharma Postgraduate Institute of Medical Sciences
Rohtak, Haryana, India
Managing Editor
Dheeraj Shah MD FIAP MNAMS
Professor Department of Pediatrics University College of Medical Sciences Guru Teg Bahadur Hospital
New Delhi, India
Forewords
Digant D Shastri, Bakul Jayant Parekh
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Principles of Pediatric and Neonatal Emergencies
First Edition: 1994
Second Edition: 2004
Third Edition: 2011
Fourth Edition: 2020
9789389587203
Printed at:
- Aashay A Shah MD
- Senior Resident and Fellow
- Department of Pediatrics
- Gastroenterology and Hepatology and Nutrition
- Medanta—The Medicity
- Gurugram, Haryana, India
- Abhay K Shah MD DPed FIAP
- Senior Consultant Pediatrician and Infectious Diseases Specialist
- Director
- Dr Abhay K Shah Children Hospital
- Maninagar
- Ahmedabad, Gujarat, India
- Abhijeet Saha MD
- Professor
- Department of Pediatrics
- Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India
- Aditi Sinha MD
- Assistant Professor
- Division of Nephrology
- Department of Pediatrics
- All India Institute of Medical Sciences
- New Delhi, India
- Ajay N Gangopadhyay MBBS MS MCh
- Ex-Professor
- Department of Pediatric Surgery
- Institute of Medical Sciences
- Banaras Hindu University
- Varanasi, Uttar Pradesh, India
- Aman Elwadhi MD
- Senior Resident
- Department of Pediatrics
- Lady Hardinge Medical College and Associated
- Kalawati Saran Children's Hospital
- New Delhi, India
- Amber Kumar MD FNB
- Assistant Professor
- Department of Pediatrics
- All India Institute of Medical Sciences
- Bhopal, Madhya Pradesh, India
- Amir Maroof Khan MD
- Associate Professor
- Department of Community Medicine
- University College of Medical Sciences
- New Delhi, India
- Amit Kumar Satapathy MD
- Assistant Professor
- Department of Pediatrics
- All India Institute of Medical Sciences
- Bhubaneswar, Odisha, India
- Amitabh Singh MD
- Assistant Professor
- Department of Pediatrics
- Vardhman Mahavir Medical College and Safdarjung Hospital
- New Delhi, India
- Anil Sachdev MD
- Director
- Pediatric Emergency
- Critical Care and Pulmonology
- Sir Ganga Ram Hospital
- New Delhi, India
- Anil Vasudevan MD
- Professor and Head
- Department of Pediatric Nephrology
- St John's Medical College Hospital
- Bengaluru, Karnataka, India
- Aniruddha Ghosh MD DNB
- Senior Resident
- Department of Pediatrics
- Institute of Child Health
- Kolkata, West Bengal, India
- Anita Saxena MD DM FACC
- Professor
- Department of Cardiology
- All India Institute of Medical Sciences
- New Delhi, India
- Anju Seth MD
- Director Professor
- Department of Pediatrics
- Lady Hardinge Medical College and Associated
- Kalawati Saran Children's Hospital
- New Delhi, India
- Anju Virmani MD DNB
- Associate Director
- Pediatric Endocrinology
- Max Smart Superspecialty Hospital
- Saket, New Delhi
- Pentamed Hospital and Rainbow Hospital, New Delhi and
- Max Hospital, Gurugram, Haryana, India
- Ankit Vishwani MD
- Senior Resident
- Department of ENT
- University College of Medical Sciences and Guru Teg Bahadur Hospital
- New Delhi, India
- Ankita Goel Sharma MD
- Associate Professor
- Department of Pediatrics
- Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital
- New Delhi, India
- Anshu Srivastava MD DM
- Professor
- Department of Pediatric Gastroenterology
- Sanjay Gandhi Postgraduate Institute of Medical Sciences
- Lucknow, Uttar Pradesh, India
- Anup Mohta MS MCh FAMS
- Director-Professor
- Department of Surgery
- Lady Hardinge Medical College
- New Delhi, India
- Anurag Agarwal MD
- Associate Professor
- Department of Pediatrics
- Maulana Azad Medical College
- New Delhi, India
- Anuva Bansal MD
- Senior Resident
- Department of Dermatology and Sexually Transmitted Diseases
- Maulana Azad Medical College and Associated Lok Nayak Hospital and
- GB Pant Hospital
- New Delhi, India
- Aparajita Mitra MS MCh Post-doctoral Fellowship in Pediatric Urology
- Assistant Professor
- Department of Pediatric Surgery
- All India Institute of Medical Sciences
- New Delhi, India
- Arohi Gupta MBBS MD
- Senior Resident
- Department of Pediatrics
- Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital
- New Delhi, India
- Arpana Iyengar MD
- Professor
- Department of Pediatric Nephrology
- St John's Medical College Hospital
- Bengaluru, Karnataka, India
- Arun Goel MD
- Consultant Plastic Surgeon and
- Unit Head
- Department of Burns and
- Plastic Surgery
- Maulana Azad Medical College and Associated Lok Nayak Hospital
- New Delhi, India
- Arun Kumar MD MRCP FRCPCH
- Consultant Pediatrician
- Croydon University Hospital
- Surrey, UK
- Arushi Gahlot Saini MD DM
- Assistant Professor
- Pediatric Neurology Unit
- Department of Pediatrics
- Postgraduate Institute of Medical Education and Research
- Chandigarh, India
- Arvind Bagga MD FIAP FAMS FISN
- Professor
- Division of Nephrology
- Department of Pediatrics
- All India Institute of Medical Sciences
- New Delhi, India
- Ashish Suri MBBS MCh DNB MNAMS
- Professor and Unit Head
- Department of Neurosurgery
- All India Institute of Medical Sciences
- New Delhi, India
- Ashok K Patwari MD MNAMS FIAP FAMS
- Former Director Professor Pediatrics
- Lady Hardinge Medical College
- New Delhi
- Former Research Professor
- International Health
- Boston University School of Public Health
- Boston, USA
- Ashutosh Yajurvedi Dch Fellowship in Neonatology
- Consultant Pediatrician, Yajurvedi Hospital
- Solapur, Maharashtra, India
- Atul Kulkarni MD
- Assistant Professor
- Department of Pediatrics
- Ashwini Rural Medical College
- Solapur, Maharashtra, India
- Atul Mohan Kochhar
- MD DNB MNAMS FAAD
- Professor and Consultant
- Department of Dermatology and Sexually Transmitted Diseases,
- Lok Nayak Hospital and associated MAMC and GB Pant Hospital
- New Delhi, India
- Baljeet Maini MD
- Professor
- Department of Pediatrics
- Teerthankar Mahaveer Medical College and Research Center
- Teerthankar Mahaveer University
- Moradabad, Uttar Pradesh, India
- Bharat Choudhary MD FPEM
- Fellow of Academic College of Emergency Experts (FACEE)
- Assistant Professor
- Trauma and Emergency (Pediatrics)
- All India Institute of Medical Sciences
- Jodhpur, Rajasthan, India
- Bharat Mehra MD
- Fellow
- Pediatric Intensive Care Unit
- Sir Ganga Ram Hospital
- New Delhi, India
- Bhavna Dhingra MD DNB
- Additional Professor
- Department of Pediatrics
- All India Institute of Medical Sciences
- Bhopal, Madhya Pradesh, India
- Bhupeshwari Patel MD FACEE
- Assistant Professor
- Department of Pediatrics
- All India Institute of Medical Sciences
- Bhopal, Madhya Pradesh, India
- Bhushan Sagade MS
- Clinical Associate
- Department of Pediatric Orthopedics
- BJ Wadia Hospital for Children
- Mumbai, Maharashtra, India
- Bilal Khan MD
- Attending Consultant
- Pediatric Intensive Care Unit
- Fortis Memorial Research Institute
- Gurugram, Haryana, India
- Bindiya Gupta MD MAMS FICOG
- Associate Professor
- Department of Obstetrics and Gynecology
- University College of Medical Sciences and Guru Teg Bahadur Hospital
- New Delhi, India
- Bipin Jose MD MRCPCH
- Consultant Pediatric Intensivist
- Rajagiri Hospital
- Kochi, Kerala, India
- Biraj Parjauli MD DM
- Fellow, Pediatric Critical Care
- Division of Pediatric Emergency and Intensive Care
- Advanced Pediatrics Center
- Postgraduate Institute of Medical Education and Research
- Chandigarh, India
- Chandra Mohan Kumar MD PGDAP MAMS
- Professor
- Department of Pediatrics and Adolescent Medicine
- Hamdard Institute of Medical Sciences and Research
- New Delhi, India
- Chhaya Sambharya Prasad MD
- Developmental Pediatrician
- Director
- Accredited Social Health Activist
- Center for Autism and Intellectual Developmental Disorders
- Chandigarh, India
- Christy Cathreen Thomas MD
- Fellow
- Division of Nephrology
- Department of Pediatrics
- All India Institute of Medical Sciences
- New Delhi, India
- Daniel Krich MD
- Fellow in Pediatric Pulmonology
- New York Medical College
- Maria Fareri Children's Hospital at Westchester Medical Center
- New York, USA
- Deepak K Gupta MBBS MS MCh
- Professor
- Department of Neurosurgery
- Neurosciences Center and Associated JPN Apex Trauma Center
- All India Institute of Medical Sciences
- New Delhi, India
- Deepak Kumar MD
- Assistant Professor
- Department of Pediatrics
- Maulana Azad Medical College
- New Delhi, India
- Deepak Sharma MD
- Consultant
- Department of Neonatology
- Fernandez Hospital
- Hyderabad, Telangana, India
- Deepika Harit MD
- Associate Professor
- Department of Pediatrics
- University College of Medical Sciences and Guru Teg Bahadur Hospital
- New Delhi, India
- Dheeraj Shah MD FIAP MNAMS
- Professor
- Department of Pediatrics
- University College of Medical Sciences and Guru Teg Bahadur Hospital
- New Delhi, India
- Dhiren Gupta MD
- Co-Director
- Pediatric Intensive Care
- Sir Ganga Ram Hospital
- New Delhi, India
- Dinesh Raj MD
- Associate Consultant
- Department of Pediatrics
- Holy Family Hospital
- New Delhi, India
- Dipen Vasudev Patel MD
- Professor
- Department of Pediatrics
- Pramukhswami Medical College
- Anand, Gujarat, India
- Dipti Kapoor MD
- Associate Professor
- Department of Pediatrics
- Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital
- New Delhi, India
- Divya Chauhan MD
- Senior Resident
- Department of Obstetrics and Gynecology
- University College of Medical Sciences and Guru Teg Bahadur Hospital
- New Delhi, India
- G Kalra MDS
- Reader
- Sardar Patel PG Institute of Dental and Medical Sciences
- Lucknow, Uttar Pradesh, India
- Garima Gupta MD
- Assistant Professor
- Department of Pediatrics
- North Delhi Municipal Corporation Medical College
- New Delhi, India
- Girish Chandra Bhatt MD MAMS
- Associate Professor
- Department of Pediatrics
- All India Institute of Medical Sciences
- Bhopal, Madhya Pradesh, India
- HPS Sachdev MD FAMS
- Senior Consultant
- Department of Pediatrics and Clinical Epidemiology
- Sitaram Bhartia Institute of Science
- and Research
- New Delhi, India
- Indumathy Santhanam MD DCH
- Professor and Head
- Department of Pediatric Emergency Medicine
- Institute of Child Health
- Madras Medical College
- Chennai, Tamil Nadu, India
- Javed Ismail MD DM
- Consultant
- Pediatric Critical Care
- Apollo KH Hospitals
- Vellore, Tamil Nadu, India
- Jaya Shankar Kaushik MD DNB DM
- Associate Professor
- Department of Pediatrics
- Pandit Bhagwat Dayal Sharma Postgraduate Institute of Medical Sciences
- Rohtak, Haryana, India
- Jayashree M MD FIAP FICCM
- Professor and Chief
- Division of Pediatric Emergency and Intensive Care
- Advanced Pediatrics Center
- Postgraduate Institute of Medical Education and Research
- Chandigarh, India
- Jayendra Seetharaman MD
- Senior Resident
- Department of Pediatric Gastroenterology
- Sanjay Gandhi Postgraduate Institute of Medical Sciences
- Lucknow, Uttar Pradesh, India
- Jhuma Sankar MD
- Associate Professor
- Department of Pediatrics
- All India Institute of Medical
- Sciences
- New Delhi, India
- Jitendra Meena MD
- Senior Resident
- Division of Nephrology
- Department of Pediatrics
- All India Institute of Medical
- Sciences
- New Delhi, India
- JK Dhillon MDS
- Ex-Associate Professor
- Department of Pedodontics and Preventive Dentistry
- Maulana Azad Institute of Dental Sciences
- New Delhi, India
- Jogender Kumar DM
- Assistant Professor
- Newborn Unit
- Department of Pediatrics
- Postgraduate Institute of Medical Education and Research
- Chandigarh, India
- Joseph John MD DNB
- Additional Professor and Head
- Department of Pediatrics
- All India Institute of Medical Sciences
- Bhubaneswar, Odisha, India
- Joseph L Mathew MD PhD Fellow
- (Ped Respirology)
- Professor
- Division of Pediatric Pulmonology
- Advanced Pediatrics Center
- Postgraduate Institute of Medical Education and Research
- Chandigarh, India
- Kana Ram Jat MD
- Associate Professor
- Division of Pediatric Pulmonology
- Department of Pediatrics
- All India Institute of Medical Sciences
- New Delhi, India
- Kausalya Raghuraman MD
- Senior Resident
- Department of Microbiology
- Pandit Bhagwat Dayal Sharma Postgraduate Institute of Medical Sciences
- Rohtak, Haryana, India
- Kavitha TK MD
- Fellow, Pediatric Critical Care
- Division of Pediatric Emergency and Intensive Care
- Advanced Pediatrics Center
- Postgraduate Institute of Medical Education and Research
- Chandigarh, India
- Krishan Chugh MD MNAMS FISCCM
- Director and Head
- Department of Pediatrics and Pediatric Intensive Care Unit
- Fortis Memorial Research Institute
- Gurugram, Haryana, India
- Krishna Mohan Gulla MD DM
- Assistant Professor
- Department of Pediatrics
- Advanced Pediatric Center
- Postgraduate Institute of Medical Education and Research
- Chandigarh, India
- Kuntal Roy Chowdhuri MS MCh
- Associate Consultant
- Department of Cardiothoracic and Vascular Surgery
- BM Birla Heart Research Center
- Kolkata, West Bengal, India
- Lalitha Janakiraman MD DCH
- Senior Consultant Pediatrician
- Kanchi Kamakoti CHILDS Trust
- Hospital and
- The CHILDS Trust Medical Research Foundation
- Chennai, Tamil Nadu, India
- Lokesh Guglani MD FAAP
- Associate Professor
- Division of Pulmonology
- Allergy/Immunology
- Cystic Fibrosis and Sleep
- Department of Pediatrics
- Emory University School of Medicine Children's Healthcare of
- Atlanta-Egleston
- Atlanta, Georgia, USA
- Madhuradhar Chegondi MBBS MD FAAP
- Consultant
- Division of Critical Care Medicine Stead Family Children's Hospital
- Assistant Professor
- Department of Pediatrics
- University of Iowa
- Carver College of Medicine
- Iowa City, Iowa, USA
- Mahesh Kamate MD DM
- Professor
- Department of Pediatric Neurology
- KAHER's Jawaharlal Nehru Medical College
- Belagavi, Karnataka, India
- Mahesh Maheshwari MD
- Associate Professor
- Department of Pediatrics
- All India Institute of Medical Sciences
- Bhopal, Madhya Pradesh, India
- Mandar Agashe MS
- Consultant Pediatric Orthopedic Surgeon
- Director
- Agashe's Pediatric Superspecialty Care
- Kurla, Mumbai
- Assistant Honorary Consultant
- BJ Wadia Hospital for Children
- Mumbai, Maharashtra, India
- Maninder Dhaliwal DNB
- Associate Director
- Pediatric Critical Care Unit
- Department of Pediatrics
- Medanta—The Medicity
- Gurugram, Haryana, India
- Manish Kori MD
- Consultant
- Pediatric Intensive Care Unit
- Fortis Memorial Research Institute
- Gurugram, Haryana, India
- Mehak Bansal MBBS DNB IDPCCM
- Clinical Fellow (Pediatric Intensive Care Unit), Great Ormond Street Hospital
- London, UK
- Mukta Mantan MD DNB
- Professor
- Department of Pediatrics
- Maulana Azad Medical College and Associated Hospitals
- New Delhi, India
- Nandkishor S Kabra MD DNB DM
- Director, Neonatal Intensive Care Unit
- Department of Neonatology
- Surya Hospitals
- Mumbai, Maharashtra, India
- Narendra Kumar Bagri MD
- Assistant Professor
- Division of Rheumatology
- Department of Pediatrics
- All India Institute of Medical Sciences
- New Delhi, India
- Naveen Sankhyan MD DM
- Additional Professor
- Pediatric Neurology Unit
- Department of Pediatrics
- Postgraduate Institute of Medical Education and Research
- Chandigarh, India
- Neelam Mohan MD
- Director
- Department of Pediatric Gastroenterology
- Hepatology and Liver Transplantation
- Medanta—The Medicity
- Gurugram, Haryana, India
- Neelima Gupta MD
- Director Professor
- Department of ENT
- University College of Medical Sciences and Guru Teg Bahadur Hospital
- New Delhi, India
- Neeraj Gupta MD DM
- Additional Professor
- Department of Neonatology
- All India Institute of Medical Sciences
- Jodhpur, Rajasthan, India
- Neha Rastogi MD
- Consultant
- Department of Pediatric Hematology
- Oncology and Bone Marrow Transplantation
- Cancer Institute
- Medanta—The Medicity
- Gurugram, Haryana, India
- Neha Thakur MD FACEE
- Assistant Professor
- Department of Pediatrics
- Dr Ram Manohar Lohia Institute of Medical Sciences
- Lucknow, Uttar Pradesh, India
- Nidhi Bedi MD
- Assistant Professor
- Department of Pediatrics
- Hamdard Institute of Medical Sciences and Research
- New Delhi, India
- P Ramesh Menon MD
- Assistant Professor (Neonatology)
- Department of Pediatrics
- All India Institute of Medical Sciences
- New Delhi, India
- Parvathi U Iyer MD
- Director
- Pediatric Cardiac Intensive Care
- Fortis Escorts Heart Institute
- New Delhi, India
- Payal Gupta DNB
- Fellow in Pediatric Ophthalmology
- Sadguru Netra Chikitsalaya
- Chitrakoot, Madhya Pradesh, India
- Peeyush Jain MD
- Senior Consultant
- Department of Pediatrics
- Hindu Rao Hospital and North Delhi Municipal Corporation Medical College
- New Delhi, India
- Pinky Meena MD
- Senior Resident
- Department of Pediatrics
- University College of Medical Sciences
- New Delhi, India
- Piyush Gupta MD FIAP FNNF FAMS
- Professor and Head
- Department of Pediatrics
- University College of Medical
- Sciences and Guru Teg Bahadur
- Hospital
- New Delhi, India
- Pooja Dewan MD MNAMS FIAP
- Professor
- Division of Hemato-Oncology
- Department of Pediatrics
- University College of Medical Sciences
- New Delhi, India
- Pooja P Mallya DNB
- Junior Consultant
- Pediatric Hematology
- Oncology and Blood and Marrow Transplantation
- Mazumdar Shaw Cancer Center
- Narayana Health City
- Bengaluru, Karnataka, India
- Pranav Gupta MBBS DNB MRCPCH
- Consultant
- Department of Pediatrics
- Tirath Ram Shah Hospital
- New Delhi, India
- Praveen Khilnani MD
- Senior Consultant Pediatric
- Pulmonology and Critical Care
- Clinical Director
- Madhukar Rainbow Children's Hospital
- New Delhi, India
- Parveen Kumar Antil MD
- Senior Resident
- Department of Pediatrics
- Maharishi Markandeshwar Institute
- of Medical Sciences and Research
- Ambala, Haryana, India
- Praveen Kumar MD DM
- Professor and Head
- Division of Neonatology
- Department of Pediatrics
- Postgraduate Institute of Medical Education and Research
- Chandigarh, India
- Praveen Kumar MD
- Director Professor
- Department of Pediatrics
- Lady Hardinge Medical College and Associated
- Kalawati Saran Children's Hospital
- New Delhi, India
- Preeti Anand MBBS DNB
- Consultant
- Pediatrics and Pediatric Intensive Care
- Max Smart Superspecialty Hospital
- Saket, New Delhi, India
- Preeti Jain MD
- Professor
- Department of Physiology
- Maulana Azad Medical College
- New Delhi, India
- Preeti Singh MD
- Assistant Professor
- Department of Pediatrics
- Lady Hardinge Medical College and Associated
- Kalawati Saran Children's Hospital
- New Delhi, India
- Prerna Batra MD MNAMS FACEE
- Professor
- Department of Pediatrics
- University College of Medical Sciences and Guru Teg Bahadur Hospital
- New Delhi, India
- Priyanka Aggarwal MD
- Assistant Professor
- Division of Pediatric Hematology Oncology
- Department of Pediatrics
- Institute of Medical Sciences
- Banaras Hindu University
- Varanasi, Uttar Pradesh, India
- Priyanka Madaan MD DM
- Senior Research Associate
- Pediatric Neurology Unit
- Department of Pediatrics
- Postgraduate Institute of Medical Education and Research
- Chandigarh, India
- R Ganesh MBBS DNB MNAMS MRCPCH PhD
- Senior Consultant Pediatrician
- Rainbow Children's Hospital
- Chennai, Tamil Nadu, India
- Rachna Pasi DCH DNB MNAMS (PhD)
- Assistant Professor
- Department of Pediatrics
- Himalayan Institute of Medical Sciences
- Dehradun, Uttarakhand, India
- Rachna Bhargava PhD
- Additional Professor of Clinical Psychology
- National Drug Dependence Treatment Center
- Department of Psychiatry
- All India Institute of Medical Sciences
- New Delhi, India
- Rachna Seth MD
- Professor
- Division of Pediatric Oncology
- Chair
- InPoG Late Effects Subcommittee
- Department of Pediatrics
- All India Institute of Medical Sciences
- New Delhi, India
- Rajeshwari Nataraj DNB
- Senior Consultant
- Pediatric Intensive Care Unit
- and Cardiothoracic Intensive Care Unit
- Apollo Children's Hospital
- Chennai, Tamil Nadu, India
- Rajniti Prasad MD
- Professor and Head
- Department of Pediatrics
- Institute of Medical Sciences
- Banaras Hindu University
- Varanasi, Uttar Pradesh, India
- Rakesh Lodha MD
- Professor
- Department of Pediatrics
- All India Institute of Medical Sciences
- New Delhi, India
- Raman Deep MD
- Additional Professor of Psychiatry
- Department of Psychiatry
- All India Institute of Medical Sciences
- New Delhi, India
- Rangan Srinivasaraghavan MD
- Assistant Professor
- Developmental Pediatrics Unit
- Department of Child Health
- Christian Medical College
- Vellore, Tamil Nadu, India
- Ranjith Kumar Manokaran MD DM
- Assistant Professor
- Pediatric Neurology
- Sri Ramachandra Medical College
- Chennai, Tamil Nadu, India
- Reshma Aramanadka MD DM
- Fellow, Pediatric Critical Care
- Division of Pediatric Emergency and Intensive Care
- Advanced Pediatrics Center
- Postgraduate Institute of Medical Education and Research
- Chandigarh, India
- Rhishikesh P Thakre DCH MD DNB DM FCPS FIAP
- Director
- Neo Clinic and Hospital
- Aurangabad, Maharashtra, India
- Rishi Bolia MD DM
- Assistant Professor
- Division of Pediatric Gastroenterology
- Department of Gastroenterology
- Postgraduate Institute of Medical Education and Research
- Chandigarh, India
- Ritabrata Kundu MD FIAP
- Professor
- Department of Pediatrics
- Institute of Child Health
- Kolkata, West Bengal, India
- Ruchi Rai MD
- Professor
- Department of Neonatology-Maternal and Reproductive Health
- Superspecialty Pediatric Hospital and Postgraduate Teaching Institute
- NOIDA, Uttar Pradesh, India
- S Mahadevan MD PhD MNAMS
- Professor and Head
- Department of Pediatrics
- Women and Children Hospital
- Jawaharlal Institute of Postgraduate Medical Education and Research
- Puducherry, India
- Samriti Gupta MD
- Assistant Professor
- Department of Pediatrics
- Dr Rajendra Prasad Government Medical College
- Kangra, Himachal Pradesh, India
- Sandeep Kumar Kanwal MD PDCDM
- Consultant
- Division of Pediatric Intensive Care Unit
- Department of Pediatrics
- Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital
- New Delhi, India
- Sangeetha Yoganathan MD DNB DM
- Professor
- Department of Neurological Sciences
- Christian Medical College
- Vellore, Tamil Nadu, India
- Sankaran Krishnan MPH FAAP
- Associate Professor of Pediatrics and Clinical Public Health
- Associate Program Director
- Pediatric Pulmonology
- New York Medical College
- Maria Fareri Children's Hospital at Westchester Medical Center
- New York, USA
- Satinder Aneja MD
- Professor
- Department of Pediatrics
- School of Medical Sciences and
- Research
- Sharda University
- Greater Noida, Uttar Pradesh, India
- Satish Kumar Aggarwal Ms MCh
- Chairman
- Pediatric Surgery
- Sir Ganga Ram Hospital
- Formerly Director Professor of Pediatric Surgery
- Maulana Azad Medical College and Associated Lok Nayak and GB Pant Hospitals
- New Delhi, India
- Satvik Bansal MD Fellowships in Neonatology
- Assistant Professor
- Department of Pediatrics
- Gajra Raja Medical College
- Gwalior, Madhya Pradesh, India
- Shalu Gupta MD DM
- Professor
- Department of Pediatrics
- Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital
- New Delhi, India
- Shalu Jain DNB
- Senior Resident
- Department of Pediatrics
- University College of Medical Sciences and Guru Teg Bahadur Hospital
- New Delhi, India
- Sharmila B Mukherjee MD
- Professor
- Department of Pediatrics
- Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital
- New Delhi, India
- Sharada Sathish Kumar DCH DNB FPEM
- Consultant
- Emergency Medicine Unit
- Mehta's Children's Hospital
- Chennai, Tamil Nadu, India
- Shashi Kant Dhir MD
- Senior Resident
- Division of Neonatology
- Department of Pediatrics
- Postgraduate Institute of Medical Education and Research
- Chandigarh, India
- Sheffali Gulati MD FAMS
- Professor
- DM Pediatric Neurology Program
- Faculty In-Charge
- Center of Excellence and Advanced Research on Childhood Neurodevelopmental Disorders
- Chief
- Child Neurology Division
- Department of Pediatrics
- All India Institute of Medical Sciences
- New Delhi, India
- Shipra Agrawal MD
- Senior Resident
- Department of Pediatrics
- Maulana Azad Medical College and Associated Hospitals
- New Delhi, India
- Shiv Sajan Saini MD DM
- Assistant Professor
- Division of Neonatology
- Department of Pediatrics
- Postgraduate Institute of Medical Education and Research
- Chandigarh, India
- Shweta Kedia
- MBBS MS MCh
- Associate Professor
- Department of Neurosurgery
- All India Institute of Medical Sciences
- New Delhi, India
- Siddarth Ramji MD FNNF
- Director-Professsor
- Department of Neonatology
- Maulana Azad Medical College and Associated Lok Nayak Hospital
- New Delhi, India
- SK Kabra MD FIAP FAMS
- Professor
- Department of Pediatrics
- All India Institute of Medical Sciences
- New Delhi, India
- Somashekar M Nimbalkar MD
- Professor
- Department of Pediatrics
- Pramukhswami Medical College
- Anand, Gujarat, India
- Sonali Ghosh MD
- Associate Consultant
- Pediatric Intensive Care Unit
- Fortis Memorial Research Institute
- Gurugram, Haryana, India
- Soonu Udani MD
- Medical Director and Head
- Critical Care and Emergency Services
- SRCC Children's Hospital Managed by Narayana Health
- Mumbai, Maharashtra, India
- Sourabh Dutta PhD MD
- Professor
- Newborn Unit
- Department of Pediatrics
- Postgraduate Institute of Medical Education and Research
- Chandigarh, India
- Srikant Das MD
- Assistant Professor
- Department of Pediatrics
- Director of Pediatric Electrophysiology
- University of Arkansas for Medical Sciences
- Little Rock, Arkansas, USA
- Srinivas Murki MD DM
- Chief Neonatologist
- Paramitha Children's Hospital
- Hyderabad, Telangana, India
- Suchitra Ranjit MD FCCM
- Consultant In-Charge
- Pediatric Intensive Care Unit
- Apollo Children's Hospital
- Chennai, Tamil Nadu, India
- Sumaira Khalil DNB
- Pediatric Specialist
- Vardhman Mahavir Medical College and Safdarjung Hospital
- New Delhi, India
- Sunil Bhat MD FNB
- Director and Clinical Lead
- Pediatric Hematology, Oncology and Blood and Marrow Transplantation
- Narayana Health Network Hospitals
- SRCC NH Children's Hospital
- Mumbai, India
- Mazumdar Shaw Cancer Center
- Narayana Health City
- Bengaluru, Karnataka, India
- Sunita Bijarnia-Mahay DCH DNB FGMM
- Senior Consultant
- Institute of Medical Genetics and Genomics
- Associate Professor
- Ganga Ram Institute of Postgraduate Medical Education and Research
- Sir Ganga Ram Hospital
- New Delhi, India
- Surender K Yachha MD DM
- Head
- Department of Pediatric Gastroenterology
- Hepatology and Liver Transplant
- Sakra World Hospital
- Bengaluru, Karnataka, India
- Suresh Gupta MD
- Senior Consultant
- Pediatric Emergency and Critical Care
- Institute of Child Health
- Sir Ganga Ram Hospital
- New Delhi, India
- Suresh Kumar Angurana
- MD DM MNAMS FIMSA FCCP
- Assistant Professor
- Division of Pediatric Critical Care
- Department of Pediatrics
- Advanced Pediatrics Center
- Postgraduate Institute of Medical Education and Research
- Chandigarh, India
- Swathi Chacham MBBS MD DM MAMS
- Additional Professor
- Former Head
- Department of Pediatrics
- All India Institute of Medical Sciences
- Rishikesh, Uttarakhand, India
- Tsering Sandup MCh
- Senior Resident
- Cardiothoracic and Vascular Surgery
- All India Institute of Medical Sciences
- New Delhi, India
- Ujjal Poddar MD DNB DM
- Professor and Head
- Department of Pediatric Gastroenterology
- Sanjay Gandhi Postgraduate Institute of Medical Sciences
- Lucknow, Uttar Pradesh, India
- Urmila Jhamb MD
- Director-Professor and Head
- Department of Pediatrics
- Maulana Azad Medical College
- New Delhi, India
- Utpal Kant Singh MD
- Professor
- Department of Pediatrics
- Nalanda Medical College
- Patna, Bihar, India
- Utkarsh Kohli MD
- Assistant Professor of Pediatrics
- Director
- Pediatric Cardiac Electrophysiology Laboratory
- Division of Pediatric Cardiology
- Department of Pediatrics
- The University of Chicago Pritzker School of Medicine
- Chicago, Illinois, USA
- Vaibhav Pandey MBBS MS MCh
- Associate Professor
- Department of Pediatric Surgery
- Institute of Medical Sciences
- Banaras Hindu University
- Varanasi, Uttar Pradesh, India
- Vineeta Gupta MD
- Professor and In-Charge
- Division of Pediatric Hematology Oncology
- Department of Pediatrics
- Institute of Medical Sciences
- Banaras Hindu University
- Varanasi, Uttar Pradesh, India
- Vivek Chaturvedi DM
- Senior Consultant
- Cardiology and Director Cardiac Electrophysiology and Pacing
- Narayana Superspecialty Hospital
- Gurugram, Haryana, India
- VP Mathur MDS
- Professor and Head
- Department of Pedodontics and Preventive Dentistry
- Center for Dental Education and
- Research
- All India Institute of Medical Sciences
- New Delhi, India
- Vyom Aggarwal MD DNB FRCPCH
- Senior Consultant
- Department of Pediatrics
- Tirath Ram Shah Hospital
- New Delhi, India
It is indeed a proud pleasure for me to write the “Foreword” for the 4th edition of the textbook on Principles of Pediatric and Neonatal Emergencies.
India is the second most populous country in the world and will soon overtake China in being “numero uno”. There is a growing disparity between the numbers of patients per doctor as well as a definite deficit of Emergency Physicians. By and large in most of the hospitals the doctors working in the casualty department or the emergency room are mostly resident/intern or medical officer who evaluates the patient and calls what they determine is the relevant specialty to take over the case. Their job is not just limited to primary evaluation, first aid and calling the specialist, but they need to initiate the emergency management also. In view of these, there is the need for a book on emergency management in Indian context which can be of help to these workforce who work in situations where each second is precious.
The Indian Academy of Pediatrics is constantly working towards improving child health in our country and to achieve its mission statement, it works through knowledge update of doctors. Apart from conducting conferences and CMEs, it also publishes journals and textbooks. This textbook on Principles of Pediatric and Neonatal Emergencies is a venture of Indian Pediatrics, Journal of the Indian Academy of Pediatrics, can be of great help as reference manual for not only the people who are working in casualty/emergency room but also to primary care pediatricians.
This multi-author book has been extremely well planned with eight sections under which through 91 chapters, all aspects of pediatric emergency care are very well covered. Common pediatric and neonatal emergencies have been authored by leading experts in their subspecialty. This ensures that all the recent advances in respective sub-specialties have been updated. Apart from sections on pediatric and neonatal medical emergencies, the book has many new facets including organization of emergency department, initial stabilization, and pediatric surgical emergencies that are often overlooked otherwise. Section on emergency procedures have been outlined very well and will be very useful to residents in training. The two Annexures on pediatric drug dosage and reference values surely proved to be great usefulness for the clinicians in routine emergency care.
The book has simple tables, algorithms and flowcharts for a quick view. This book covers almost everything that would be required to provide care for sick children and my compliments to all the members of the editorial board lead by a great teacher and writer Dr Piyush Gupta for their untiring efforts.
This comprehensive textbook with excellent illustrations would motivate young budding residents and will be very useful to them. I am sure this book will serve as a ready reference for every pediatrician providing emergency services to children. Apart from its place on the bookshelves of fellow pediatricians, this book must be present in every pediatric emergency for ready reference. This would ensure that we provide the best of care with updated knowledge.
My best wishes and regards.
Digant D Shastri
President, Indian Academy of Pediatrics 2019
Foreword
I am delighted to write the foreword for the fourth edition of Principles of Pediatric and Neonatal Emergencies. The first edition was published in 1994 under the editorship of Dr Sachdev, Dr Puri, Dr Bagga and Dr Panna Choudhury. In fact, this first edition was also built upon on an earlier venture “Pediatric and Neonatal Emergencies”. We recognized early on the need for the various principles regarding Pediatric and Neonatal Emergencies. Dr Sachdev and his associate editors have met that need, representing many disciplines that IAP serves, and all having contributed to the evolution of the science behind pediatric and neonatal emergencies. The first edition was very well received, having been through several printings! This prompted Dr Sachdev and his team come out with the second edition in 2004 and subsequently a third edition in 2011 was published by the very eminent Dr Panna, Dr Bagga, Dr S Ramji, Dr RK Puri and Dr Piyush Gupta. Now, eight years later, Dr Piyush Gupta and his able editorial team have completely updated and revised version with several new chapters and sections using the same multidisciplinary approach that has been the hallmark of success of the previous models.
In addition to providing a practical resource containing the core science of pediatric and neonatal emergencies principles, it is designed to serve as:
- A companion resource for the practicing pediatrician;
- A valuable clinical resource for the generalist; and
- An interdisciplinary document that recognizes both the common body of knowledge and the unique skills that each member of the multidisciplinary team possesses.
All pediatricians, neonatologists and especially intensivists require a proper knowledge of pediatric and neonatal emergencies, which forms our target audience. It has covered various topics, which are of relevance in our day-to-day practice and also for the postgraduates very effectively and in detailed descriptions.
Each chapter contains evidence-based background information emphasizing core science, intended for the professional who already possesses a basic understanding of the basic principles. The fourth edition reflects new guidelines that have evolved in various disciplines, and benefits from a new formal definition along with the closure of several gaps pointed out by clinicians and reviewers. The flow of information has improved tremendously.
It is my hope and expectation that this book will provide an enhanced learning experience and referenced resource for all health professionals caring for infants and children, leading to improved patient care.
Bakul Jayant Parekh
President, Indian Academy of Pediatrics 2020
Preface to the Fourth Edition
We are delighted to present this completely revised fourth edition of Principles of Pediatric and Neonatal Emergencies, a flagship publication of Indian Pediatrics. We hope that this treatise will cater to the needs of not only general pediatricians and neonatologists, but also of all physicians involved in immediate care of children with acute illnesses. For the first time, the book has a pleasing color format with high quality paper, which will result in better visual appeal and understanding. With its focus on management of acute illnesses in emergency settings, especially in low- and middle-income settings, the book will be highly relevant to the needs of pediatricians working in developing countries.
This book continues to have the privilege of scholarly writings from illustrious authors, across the country. In the last decade, there have been major developments in various pediatric subspecialties, which have now become integral part of the broad specialty of Pediatrics. With several pediatric subspecialty courses and fellowship programs running in country, we have taken care to involve several authors who are well trained and experienced in these subspecialties, simultaneously retaining the simplicity of the presentation for benefit of general pediatricians. We express our gratitude for all old and new authors for their valuable contribution to this edition. Most chapters have been completely rewritten, incorporating latest consensus guidelines of management by various academic bodies and incorporating flowcharts and key points. The emphasis continues to be on initial management of common and important emergencies affecting children. Detailed discussions on etiology and pathophysiology have been avoided.
We hope that this textbook shall be extremely valuable for pediatricians, physicians, resident doctors and other trainees, and will be an essential part of shelf in all pediatric emergency units. As before, all the royalties generated from the sale of the book shall pass onto the journal Indian Pediatrics.
We are grateful to M/s Jaypee Brothers Medical Publishers (P) Ltd., New Delhi, India for their meticulous typesetting, heeding to all our requests, and expeditious publication.
Dheeraj Shah
Editor-in-Chief, Indian Pediatrics (2014–2019)
on behalf of the Editorial Team of the Book
Preface to the First Edition
For the practitioners of pediatric care, emergencies in children and neonates are an inescapable fact in their daily routine. Better understanding of pathophysiology and drug metabolism and availability of newer investigative and diagnostic facilities have led to the creation of new frontiers in this important subject. Prompt recognition and appropriate management of these emergencies make the difference between life and death. A variety of traditional western textbooks provide information on this topic. However, this updated knowledge is often not relevant for the developing world situation.
Inspired by the success of its earlier venture titled Pediatric and Neonatal Emergencies, Indian Pediatrics—the official journal of the Indian Academy of Pediatrics, took up the formidable challenge of providing comprehensive state-of-the-art information on the subject which would also be pertinent in the Indian milieu. The present publication has been extensively updated and enlarged from the earlier experiment, which now appears like a distant cousin. Guidelines have also been incorporated for organization of pediatric intensive care units.
We are indebted to the group of distinguished contributors who promptly responded to our call, despite constraints of their busy schedules.
This volume is intended for the pediatricians and physicians sharing initial contact with emergencies in children and neonates as well as those responsible for the subsequent critical and intensive care. Postgraduate students should find it of particular help. The book should also prove invaluable for all current and intended pediatric emergency care units.
The editors share of financial benefits from the royalties would accrue to the Indian Pediatrics in an attempt to make the journal self-sufficient. We are grateful to the publishers for ensuring the high quality of the book as well as its expeditious publication.
This volume is dedicated to the memory of late Dr Man Mohan, an active associate in the earlier venture.
HPS Sachdev
RK Puri
New Delhi
A Bagga
February, 1994
P Choudhury