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Neonates - Anthony Iacolucci
05/30/2025
Neonates - Anthony Iacolucci
Neonates are one of the most feared patient populations in EMS—and for good reason. In this episode, Zach Cantor talks with Anthony Iacolucci, a pediatric respiratory therapist and paramedic, about how to confidently approach neonatal calls. Anthony introduces NEO SECRETS, a practical acronym covering the top 10 causes of neonatal illness, and offers insight into assessment, common pitfalls, and key treatment considerations. NEO SECRETS Breakdown: • N – Inborn errors of metabolism • E – Electrolyte abnormalities • O – Overdose or toxic exposure • S – Sepsis (the leading cause of neonatal mortality) • E – Endocrine crisis (e.g., hypoglycemia, adrenal insufficiency) • C – Cardiac conditions (cyanotic vs. acyanotic presentations) • R – Recipe or formula mishaps (e.g., dilution errors leading to hyponatremia) • E – Enteric emergencies (e.g., malrotation with volvulus, gastroenteritis) • T – Trauma, including accidental and non-accidental injuries • S – Seizures (often subtle and hard to recognize in neonates) Key Takeaways: • Neonates are not small adults or even small pediatric patients—they are physiologically distinct and highly vulnerable. • Early identification of sepsis, cardiac issues, and metabolic errors can save lives. • Paramedics should rely on strong assessment skills, detailed history-taking, and high suspicion for uncommon causes. • Videos, glucose checks, pre-ductal saturations, and detailed caregiver interviews are essential field tools. • Understanding neonatal physiology, presentation timelines, and risk factors improves both confidence and outcomes. Why Listen: If you’ve ever felt unprepared when faced with a neonatal call, this episode provides a clear, practical, and memorable guide to the top threats to neonates—and how to recognize and respond to them in the field.
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