Developing a Neurological and Consciousness Examination for Neonates

  • Research type

    Research Study

  • Full title

    Developing a Neurological and Consciousness Examination for Neonates

  • IRAS ID

    259148

  • Contact name

    Anthony R Hart

  • Contact email

    a.r.hart@sheffield.ac.uk

  • Sponsor organisation

    Sheffield Children's Hospitals NHS Foundation Trust

  • Duration of Study in the UK

    3 years, 0 months, 1 days

  • Research summary

    When a doctor assesses a patient, the first task they do is ask questions (the history) and perform an examination. These help determine possible diagnoses and what tests to do.

    Diseases affecting the brain, spinal cord, nerves or muscles (the neurological system) are common in newborn babies, but our pilot work shows doctors are not confident in examining the newborn baby’s neurological system and may miss out important aspects. A "standardised" neurological examination of the newborn baby with a scoring sheet exists, but it is designed for babies with birth-related brain injury or prematurity, not unwell babies in whom the cause of the problems is unknown. As a result, a new neurological examination is needed to assess unwell newborn babies thoroughly and appropriately.

    The first step of any neurological examination is assessing the patient's level of consciousness. In older children or adults, the Glasgow Coma Scale (GCS) is used routinely as a part of the neurological examination. It can also be used independently of a full examination to monitor patients on the ward, such as when the nurses do their routine observations, such as heart rate, breathing rate, temperature etc. Using the GCS this way can identify when a patient is getting better or when they are deteriorating and need medical assistance. Unfortunately, the GCS is not applicable to newborn babies in its current format.

    This project aims to:

    1) design a neurological examination suitable and safe for unwell newborn babies
    2) evaluate a coma score for newborn babies that can be used during the examination and independently during nursing observations.

    We will assess how easy these are to perform and how reproducible / acceptable they are for health care professionals involved in the care of newborn babies.

  • REC name

    East Midlands - Nottingham 1 Research Ethics Committee

  • REC reference

    19/EM/0276

  • Date of REC Opinion

    18 Oct 2019

  • REC opinion

    Further Information Favourable Opinion