Table 1 Neonatal Near-Miss Assessment Tool (NNMAT) Itemsa
From: Neonatal near-misses in Ghana: a prospective, observational, multi-center study
| Category 1: EVIDENCE OF SEVERE/LIFE THREATENING COMPLICATIONS | Category 2: CLINICAL INTERVENTIONS SUGGESTIVE OF A NEAR-MISS |
| Apgar Score < 7 at 5 min | Resuscitation (bag & mask) in the first minute |
| Gestational Age < 33 weeks | Resuscitation in the NICU (after the first minute) |
| Birthweight < 1800 g | Nasal CPAP |
| Suspected subgaleal bleed | Cardiac massage/Chest compressions |
| Major congenital abnormality requiring surgical repair (e.g. gastroschisis, hydrocephalus, duodenal artresia, congenital heart defect) | IV fluid bolus |
| Axillary temperature < 35 or > 39 | Any intubation during admission |
| Severe jaundice requiring blood exchange | Double phototherapy |
| Surgery in first week | Double blood exchange transfusion |
| Oxygen therapy | |
| IV fluid 12h hours | |
| Caffeine citrate/aminophylline therapy | |
| Thermal protection > 4 h | |
| Category 3: ORGAN DYSFUNCTION | Category 4: INVESTIGATIONS IN THE FIRST 7 DAYS |
| Cardiovascular: | Haematocrit < 30% |
| Capillary refill time > 3 s | Hemoglobin < 10gd/dl |
| Persistent tachycardia > 180 bpm | White blood cells < 4000 cells/mm3 |
| Persistent bradycardia < 80 bpm | Serum bilirubin level > 10 x gestational age |
| Cardiac arrest | Blood culture done |
| Neurologic: | Blood culture positive |
| Recurrent seizures | |
| Abnormal posturing | |
| Inability to suck | |
| Floppy | |
| Poor Feeding | |
| Weak Cry | |
| Respiratory: | |
| Tachypnea > 100 cpm | |
| Bradypnoea < 20 cpm | |
| Grunting | |
| Cyanosis in air | |
| Gasping | |
| Chest in drawing | |
| Apnea | |
| Renal: | |
| Oliguria or anuria > 24 h | |
| Gastrointestinal: | |
| Persistent vomiting | |
| Distended abdomen | |
