Acute neonatal referral pathways

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Criteria to refer to neonates from ED
  • Stable
  • Will not need a prolonged period of observation (either likely admit or likely discharge following initial review)
  • Likely PNW or TC readmission
  • If NICU admission appropriate: There is space to accommodate (preferably cubicle)
  • No viral/ infective symptoms
  • No COVID-19 symptoms (including high fever) in baby or family/ care givers
  • Not self isolating due to COVID-19 contact
  • There is no age cut off for prolonged jaundice provided it is not a new, late onset of jaundice in a previously well baby

Readmission to PNW (medical/ANNP review required at readmission)

Jaundice in an otherwise well baby

Weight loss in an otherwise well baby requiring feeding support

Readmission to Neonatal Unit

Jaundice in an unwell baby OR may need exchange transfusion OR inadequate oral feeding

Suspected sepsis

Excessive weight loss/poor feeding requiring NG feeding (consider TC if well)

Cyanotic episodes

Should be diverted to paediatric services

>14 days old 

Respiratory distress with possible viral aetiology, vomiting and loose stools

COVID 19 Symptoms or contact

Requires immediate 999 call – Sudden collapse at home

Editorial Information

Last reviewed: 01 December 2020

Next review: 31 December 2022

Author(s): Dr Jennifer Mitchell, Consultant in Neonatal medicine, Royal Hospital for Children, Glasgow

Version: 3

Co-Author(s): Stakeholders: Dr Morag Campbell – Clinical director of Neonatal medicine, Royal Hospital for Children, Glasgow; Dr Andrew Powls Clinical lead Neonatal medicine, Princess Royal Maternity, Glasgow; Dr Hilary Conetta Clinical lead Neonatal medicine, Royal Alexandra Hospital, Paisley; Dr Jonathan Coutts Clinical lead Neonatal medicine, Royal Hospital for Children, Glasgow

Approved By: GGC Neonatal Guidelines Group