The EM Educator Series: Why is my neonate so sick?

Author: Alex Koyfman, MD (@EMHighAK) // Edited by: Brit Long, MD (@long_brit) and Manpreet Singh, MD (@MprizzleER)

Welcome back to the EM Educator Series. These posts provide brief mini-cases followed by key questions to consider while working. The featured questions provide important learning points for those working with you, as well as vital items to consider in the evaluation and management of the specific condition discussed.

This week has another downloadable PDF document with questions, links and answers you can share with learners as educators in #MedEd. Please message us over Twitter and let us know if you have any feedback on ways to improve this for you. Enjoy!


A 2-week-old male is brought into the ED by his parents for decreased activity, vomiting, and decreased oral intake. His vital signs reveal fever and tachycardia. He appears lethargic, his abdomen seems to be red, and he cries when you touch his abdomen.



  • How do neonates with NEC present? What are the most common risk factors?
  • What are your considerations and the differential for the sick neonate?
  • What is the ED evaluation for suspected NEC?
  • What is the ED management for suspected NEC?


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