S-0.1, r. 4 - Regulation respecting cases requiring consultation with a physician or transfer of clinical responsibility to a physician

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(ss. 1 and 5)
Cases for mandatory consultation
(1) abnormal pigmentation
(2) birth trauma
(3) enlarged fontanelles according to criteria in effect
(4) palpable thyroid gland
(5) 1 major malformation or 2 or more minor malformations suspected or apparent at birth
(6) suspected spina bifida
(7) abnormal crying
(8) absent or abnormal primitive reflexes after sequential evaluation
(9) abnormal neurological signs
(10) heart murmur
(11) hepatomegaly > 3 cm below costal margin
(12) palpable spleen
(13) single umbilical artery
(14) inguinal mass
(15) testicular mass at birth
(16) undescended or impalpable testes
(17) 36-36 6/7 weeks gestational age
(18) clinical examination suggesting gestational age less than 37 weeks
(19) persistant tachypnea at more than 60 respirations/minute
(20) weight below the 3rd percentile
(21) failure to regain birth weight after 14 days of life, unresponsive to treatment
(22) slow or poor infant weight gain according to the growth curve adapted to the sex and race
(23) inappropriate growth less than the 3rd percentile or greater than the 97th percentile according to the head circumference curve
(24) asymmetrical skull (absence of round shape) after 3 days
(25) irritability, hypertonia if more than 24 hours
(26) anuria beyond 24 hours of life
(27) absence of the passage of meconium after 24 hours of life
(28) abnormal laboratory results that may have a clinical impact
(29) jaundice requiring phototherapy
(30) persistent jaundice after 14 days of life
(31) suspected infections in the baby, or in the mother, having a potential impact on the baby
(32) periumbilical erythema compatible with an omphalitis
(33) skin eruption other than neonatal erythema or diaper rash
(34) purulent eye discharge with redness of the conjunctiva
(35) heart beat which is abnormal or irregular, less than 100 beats/min or more than 200 beats/min
(36) impalpable or asymmetrical femoral pulses
(37) absent red reflex of the eye
(38) abdominal mass
(39) hip instability or subluxation of the hips
(40) bulging anterior fontanelle
Cases for mandatory transfer
(1) hypothermia (36 °C rectal or 35.5 °C axillary) persisting beyond 2 hours of life or hyperthermia (38.5 °C rectal or 38 °C axillary) persisting beyond 12 hours of life
(2) respiratory distress or apnoea
(3) jaundice within the first 24 hours
(4) less than 36 weeks gestational age
(5) APGAR less than 7 at 5 minutes
less than 9 at 10 minutes
(6) central cyanosis
(7) newborn having required endotracheal intubation or positive pressure ventilation beyond the second minute of life
(8) any major anomaly requiring immediate intervention
(9) persistent pallor beyond 1 hour of life
(10) unilateral or bilateral choanal atresia
(11) jitteriness or convulsions
(12) lethargy or hypotonia
(13) generalized ecchymoses or petechiae
(14) signs of withdrawal
(15) distended abdomen with food intolerance
(16) gastrointestinal hemorrhage
(17) vomiting bile or diarrhea
O.C. 455-2004, sch. V.