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.