Table 4. Domain-specific GIRISH prompt templates for neonatal clinical practice.

AAP: American Academy of Pediatrics; aEEG: Amplitude-integrated electroencephalography; AUC: Area under the curve; AXR: Abdominal radiograph; BP: Blood pressure; BPD: Bronchopulmonary dysplasia; BW: Birth weight; CHD: Congenital heart disease; CMV: Cytomegalovirus; CRP: C-reactive protein; CVL: Central venous line; CXR: Chest radiograph; DHA: Docosahexaenoic acid; DIC: Disseminated intravascular coagulation; DOL: Day of life; EBM: Expressed breast milk; ELBW: Extremely low birth weight; EOS: Early-onset sepsis; ESPGHAN: European Society for Paediatric Gastroenterology Hepatology and Nutrition; ETTNO: Effects of transfusion thresholds on neurocognitive outcome trial; FiO₂: Fraction of inspired oxygen; GA: Gestational age; GI: Gastrointestinal; GIR: Glucose infusion rate; GORD: Gastro-esophageal reflux disease; HFOV: High-frequency oscillatory ventilation; HIE: Hypoxic-ischemic encephalopathy; HR: Heart rate; IEM: Inborn errors of metabolism; IM: Intramuscular; iNO: Inhaled nitric oxide; IV: Intravenous; IVH: Intraventricular hemorrhage; LA:Ao: Left-atrium-to-aorta ratio; LMIC: Low- and middle-income country; LOS: Late-onset sepsis; MAP: Mean arterial pressure; MRI: Magnetic resonance imaging; NAS: Neonatal abstinence syndrome; NEC: Necrotizing enterocolitis; NICHD: National Institute of Child Health and Human Development; NNF: National Neonatology Forum (India); OI: Oxygenation index; pCO₂: Partial pressure of carbon dioxide; PDA: Patent ductus arteriosus; PICC: Peripherally inserted central catheter; PMA: Post-menstrual age; PPHN: Persistent pulmonary hypertension of the newborn; RDS: Respiratory distress syndrome; SIP: Spontaneous intestinal perforation; TOBY: Total body hypothermia for neonatal encephalopathy trial; TOP: Transfusion of prematures trial; TORCH: Toxoplasmosis, other, rubella, cytomegalovirus, herpes simplex; TPN: Total parenteral nutrition; UAC: Umbilical arterial catheter.

Clinical domain	Goal statement (G) – copy and adapt	Key input parameters (I)	Safety verification (S) – always do this
Respiratory (RDS, BPD, PPHN, apnea)	“Summarize evidence for [surfactant/iNO/HFOV vs SIMV] in a [GA]-week infant with [diagnosis]. State evidence grade. Do not prescribe.”	GA, BW, DOL, FiO2, MAP, OI, blood gas (pH, pCO2, base excess), surfactant history, CXR result, ventilator mode and settings, caffeine dose	iNO: OI at or above 25, term/near-term (AAP 2019). Surfactant: weight/GA-specific dosing. HFOV: set MAP, amplitude, frequency. PPHN: exclude sepsis and metabolic causes first. Use WHO guidance for LMIC settings.
Cardiovascular (PDA, CHD, shock)	“Evidence for and against medical PDA closure vs expectant management in a [GA]-week infant, [DOL], with the echo findings below. Include evidence grade. Do not prescribe.”	Echo findings (diameter, flow, LA:Ao ratio), HR, BP (MAP), capillary refill, urine output, 24 h fluid balance, respiratory support, prior indomethacin/ibuprofen	Indomethacin: contraindicated if urine output below 1 mL/kg/h. Ibuprofen: contraindicated with active GI bleed. IV paracetamol: dose by GA. Ligation: per unit protocol. Verify with senior or cardiologist.
Neurological (HIE, IVH, seizures, NAS)	“Assess therapeutic-hypothermia eligibility (TOBY [23]/NICHD [24] criteria). List criteria met, not met, and uncertainties. State what additional information is needed.”	Mode of birth, time to first cry, Apgar scores (1, 5, 10 min), cord/first-gas pH and base excess, aEEG description, neurological examination, age in hours, GA (must be at or above 36w)	Cooling window: start within 6 h of age. Eligibility: pH at or below 7.00 or base deficit at or above 16 mmol/L, and/or abnormal neurology and/or abnormal aEEG. Phenobarbitone loading: dose by weight, not GA. Levetiracetam: evidence grade B only. MRI: days 3 to 5 optimal.
Gastrointestinal (NEC, SIP, GORD, jaundice)	“Stage this infant using modified Bell’s criteria. Recommend initial management. State surgical-referral triggers. Flag evidence grade throughout.”	Abdominal findings (distension, tenderness, erythema, palpable loops), AXR result (pneumatosis, portal gas, free air), WBC, CRP, platelet count and trend, feed history and volume at presentation, stool pattern	Triple antibiotics: ampicillin, gentamicin, and metronidazole (confirm local protocol). Nil by mouth: minimum 7 to 10 days for Bell IIa/IIb. Bell IIb/III: urgent surgical consult. Antifungal prophylaxis per unit protocol in ELBW/less-than-28-week infants in high-prevalence units. Peritoneal drain vs laparotomy: discuss with surgery per local protocol.
Infectious disease (EOS, LOS, fungal, TORCH)	“Recommend empirical antibiotics for suspected LOS in the infant below. Include evidence grade and duration. State what requires culture results to determine.”	GA, PMA, DOL, prior antibiotics (agent, duration), culture results, CRP trend (last 3), access device (UAC/PICC/CVL), local antibiogram, signs of a specific focus	Gentamicin: extended-interval dosing by GA (Neofax). Vancomycin: AUC-guided monitoring preferred over trough. Amphotericin B: check renal function first. De-escalate on sensitivities within 48 to 72 hours – prompt the AI to state this.
Metabolic (hypoglycemia, IEM, TPN, electrolytes)	“Stepwise investigation algorithm for persistent hypoglycemia unresponsive to GIR above 8 mg/kg/min. Flag diagnoses requiring urgent exclusion.”	Blood-glucose trend (last 6 readings with GIR at each), current GIR, insulin level if measured, cortisol, growth hormone, lactate, ammonia, urine ketones, amino-acid screen, family history, maternal medications, gestational complications	Glucagon 200 mcg/kg IV/IM; blunted response in preterm. Diazoxide: monitor for PPHN. Octreotide: case-series only – specialist input. IEM screen: critical sample during hypoglycemia. Metabolic referral if undiagnosed at 48 hours.
Hematologic (anemia, DIC, polycythemia)	“Summarize transfusion-threshold evidence for a [GA/PMA]-week infant on [ventilatory support]. Reference TOP [25] and ETTNO [26] trial results.”	Hemoglobin trend (last 3), respiratory support and FiO2, 24 h apnea frequency, weight trend, reticulocyte count, blood group and Coombs, bilirubin, erythropoietin status	TOP [25] and ETTNO [26] (2020–2022): liberal and restrictive thresholds showed equivalent neurodevelopmental outcomes, with fewer transfusions under the restrictive approach. Use CMV-negative/irradiated products for immunocompromised infants. Platelet threshold: 25 x109/L if stable; 50 x109/L pre-procedure; 100 x109/L with active bleeding.
Nutrition and prematurity (TPN, enteral feeding, growth)	“Evidence-based enteral-advancement protocol for a [GA]-week infant, [DOL], with the feeding history below. State feed-intolerance triggers.”	GA, BW, DOL, feed volume (mL/kg/day), feed type (EBM/donor/formula), tolerance indicators, 7-day weight trend, TPN composition, NEC risk factors, fortification status	Advancement rate: up to 30 mL/kg/day increase in the very preterm. Fortification: commence at 100 mL/kg/day. Vitamin D: 400 to 800 IU/day. DHA: evidence exists, but quality is variable. Probiotics: check the national-body position (NNF India, ESPGHAN).