Episode 50 | NEOSECRETS – Anthony Iacolucci

by | May 30, 2025 | Season1 | 0 comments

In this special episode, host Zach Cantor is joined by Anthony Iacolucci—both a pediatric respiratory therapist and paramedic—to unpack the challenges of assessing and managing critically ill neonates in the pre-hospital setting. Using the acronym NEO SECRETS, they explore the ten most common causes of neonatal emergencies, providing EMS providers with practical tools, clinical pearls, and essential context.

Sponsored by: 

Anthony Iacolucci

Anthony Iacolucci is dually licensed Paramedic and Respiratory Therapist of over 25 years. He has worked clinically with York Paramedic Services as a Paramedic since 2001 and for over a decade as an Instructor in the Paramedic program at Centennial College in Toronto. 

 In his Respiratory Therapy practice, he works for the Acute Care Transport Services (ACTS) team at SickKids in Toronto as a Transport Clinician where he is one of only a few Canadian Respiratory Therapists to hold a certificate of subspecialty in Neonatal / Paediatric Transport.

ACTS is SickKids’ Neonatal / Paediatric Critical Care Transport Team and his clinical work includes being a transport team lead in the land and air transport of critically ill neonates and paediatric patients locally and internationally. He is also a frequent conference presenter on topics related to the respiratory care and stabilization of neonates. 

He can be reached on X @anthony_RRT and on LinkedIn.

Key Topics Covered:
• NEO SECRETS framework for neonatal emergencies
• Unique neonatal physiology and transitional vulnerabilities
• Common fears and knowledge gaps among paramedics
• Red flags, subtle signs, and focused assessments
• Practical field interventions and the limits of pre-hospital care
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.

 

Submit a Comment

Your email address will not be published. Required fields are marked *