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EM@3AM: The Sick Neonate

A 10-day-old female presents with her parents with poor feeding and increased work of breathing. Her urine output has been poor, but her parents have not observed fevers. She is afebrile, but her HR is 188, RR is 61, and oxygen saturation is 94% on room air. She demonstrates increased work of breathing and retractions and appears lethargic. Her serum glucose is 48. What is your next step in evaluation and management?

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