L2: Neonatal Resuscitation Flashcards
(103 cards)
1
Q
Causes of death in neonate
A
2
Q
Percentage of babies that require resuscitation
A
3
Q
Signs of compromised newborn
A
4
Q
Mechanism & TTT of 1ry Apnea
A
5
Q
Mechanism & TTT of 2ry Apnea
A
6
Q
The Neonatal Resuscitation Program Flow Diagram
A
7
Q
Risk factors predicting which babies will require resuscitation
A
8
Q
Personnel that should be present at delivery
A
9
Q
Questions that should you ask before every birth
A
10
Q
Perform a pre-resuscitation team briefing
A
11
Q
Indications of Delayed Cord clamping ‘’after 30 seconds’’
A
For both term and preterm infants who do not require resuscitation at birth
12
Q
Benefits of Delayed Cord clamping ‘’after 30 seconds’’
A
13
Q
Disadvantages of Delayed Cord clamping ‘’after 30 seconds’’
A
Higher mean serum bilirubin & use of phototherapy
14
Q
All newborns require initial assessment to determine whether resuscitation is required immediately after birth
A
15
Q
Initial Steps of Neonatal Resuscitation
A
16
Q
Neonatal Resuscitation
- Provide Warmth
A
17
Q
Neonatal Resuscitation
- Warming Methods
A
- Placing newborn under radiant warmer
- Drying thoroughly
- Removing wet towels
- Head cap
- Plastic cover
- Increase room temperature
18
Q
Neonatal Resuscitation
- Thermoregulation
A
Temperature of non-asphyxiated newborn infants be maintained between 36.5C & 37.5 after birth through resuscitation or stabilization
19
Q
Neonatal Resuscitation
- Warming Preterm Babies < 32 w GA
A
20
Q
Neonatal Resuscitation
- Opening the airway
A
21
Q
Neonatal Resuscitation
- Clear Airway = suction of secretions
A
22
Q
Neonatal Resuscitation
- Clear Airway = suction of secretions
(if no meconium)
A
23
Q
Neonatal Resuscitation
- Clear Airway = suction of secretions
(if meconium is present)
A
24
Q
Neonatal Resuscitation
- Tactile stimulation the baby to breathe or cry
A
25
**Neonatal Resuscitation**
- Dry the baby
Dry thoroughly and remove wet linens
26
**Neonatal Resuscitation**
- Initial Evaluation
- Inspect chest rise = respiration (breathing or not)
- Pulse oximetry = oxygen saturation (do not use color)
- Stethoscope at the apex of the heart = HR in 6 sec multiplied by 10 to get HR in 1 min
27
You have approximately 30 sec to achieve a response before deciding to go on to the next step
...
28
Accepted Saturation in the 1st 10 minutes after birth
29
Assessment of breathing – HR – SaO2
- 3 Scenariors
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Golden Minute
Approximately 60 seconds (“the Golden Minute”) are allotted for completing the initial steps, revaluating, and beginning ventilation if required
31
Indications of PPV
32
....... is the single most important and most effective step in CPR of the compromised infant
Ventilation of the lungs
33
Concentration of **Free Flow O2**
34
Flow Rate in **Free Flow O2**
Adjust the flow meter to 10 L/min
35
Methods to adjust **Free Flow O2**
36
What to do after **Free Flow O2**?
37
- Free-flow oxygen Cannot be given through the mask of a self-inflating bag; however, it may be given through the tail of an open reservoir
...
38
Methods of **PPV**
- Self-inflating bag
- Flow-inflating bag
- T-piece resuscitator
39
Duration of **PPV**
15 sec
40
Rate & Technique of **PPV**
41
Pressure in **PPV**
42
Steps of initiating **PPV**
43
How to place a resuscitation mask on the newborn' s face?
44
Compare between **Flow Inflating Bag** & **Self Inflating Bag**
45
Compare between **Flow Inflating Bag** & **Self Inflating Bag** in terms of:
- **Filling**
- Compressed Gas Source
- Delivered O2 Saturation
- Inflation
- Regulation of Pressure
- Assessment of Pressure
- Precautions
- Picture
46
Compare between **Flow Inflating Bag** & **Self Inflating Bag** in terms of:
- Filling
- **Compressed Gas Source**
- Delivered O2 Saturation
- Inflation
- Regulation of Pressure
- Assessment of Pressure
- Precautions
- Picture
47
Compare between **Flow Inflating Bag** & **Self Inflating Bag** in terms of:
- Filling
- Compressed Gas Source
- **Delivered O2 Saturation**
- Inflation
- Regulation of Pressure
- Assessment of Pressure
- Precautions
- Picture
48
Compare between **Flow Inflating Bag** & **Self Inflating Bag** in terms of:
- Filling
- Compressed Gas Source
- Delivered O2 Saturation
- **Inflation**
- Regulation of Pressure
- Assessment of Pressure
- Precautions
- Picture
49
Compare between **Flow Inflating Bag** & **Self Inflating Bag** in terms of:
- Filling
- Compressed Gas Source
- Delivered O2 Saturation
- Inflation
- **Regulation of Pressure**
- Assessment of Pressure
- Precautions
- Picture
50
Compare between **Flow Inflating Bag** & **Self Inflating Bag** in terms of:
- Filling
- Compressed Gas Source
- Delivered O2 Saturation
- Inflation
- Regulation of Pressure
- **Assessment of Pressure**
- Precautions
- Picture
51
Compare between **Flow Inflating Bag** & **Self Inflating Bag** in terms of:
- Filling
- Compressed Gas Source
- Delivered O2 Saturation
- Inflation
- Regulation of Pressure
- Assessment of Pressure
- **Precautions**
- Picture
52
Compare between **Flow Inflating Bag** & **Self Inflating Bag** in terms of:
- Filling
- Compressed Gas Source
- Delivered O2 Saturation
- Inflation
- Regulation of Pressure
- Assessment of Pressure
- Precautions
- **Picture**
53
Self-inflated bag
54
NEOPUFF TM Infant Resuscitator
55
After 1st assessment (1st PPV Trial)
56
After 1st PPV trial
- if HR is increasing
57
After 1st PPV trial
- if HR is not increasing but chest is moving
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After 1st PPV trial
- if HR is not increasing & chest is not moving
59
Ventilation corrective steps (MR SOPA)
60
Ventilation corrective steps (MR SOPA)
- MR
- Mask adjustment
- Reposition the head to ensure an open airway
61
Ventilation corrective steps (MR SOPA)
- SOP
- Suction the mouth and nose
- Open baby’s mouth slightly and lift the jaw forward
- Pressure Gradually / few breaths, (cautiously, & to a maximum of 40 cm H20), until there are bilateral breath sounds & visible chest movement
62
Ventilation corrective steps (MR SOPA)
- A
- Airway alternative is considered (ET tube or laryngeal mask airway)
63
**Second Assessment of PPV**
64
**Second Assessment of PPV**
- HR > 100
65
**Second Assessment of PPV**
- HR is 60-100
66
**Second Assessment of PPV**
- HR < 60
67
Signs of effective ventilation
1. increased Heart rate
2. Improving muscle tone
3. Improving color
4. Spontaneous breathing
68
Indications of **ETT** in neonatal resucitation
69
Special Indications of **ETT**
70
Indications of **Chest Compression** in neonatal Resuscitation
71
Value of **Chest Compression** in neonatal Resuscitation
72
**Chest Compression** in neonatal Resuscitation
- Site of pressure & Depth
73
**Chest Compression** in neonatal Resuscitation
- Technique
74
**Chest Compression** in neonatal Resuscitation
- Steps
75
**Chest Compression** in neonatal Resuscitation
- Complications
- Laceration of liver
- Broken ribs
75
**Chest Compression** in neonatal Resuscitation
- Coordination of chest compression with ventilation
76
**Chest Compression** in neonatal Resuscitation
- If Heart Rate Remains < 60 bpm (after doing the previous)
77
When to stop resuscitation?
78
Meds in **Neonatal Resuscitation**
- Epinephrine
- Volume Expanders
79
Epinephrine in **Neonatal Resuscitation**
- Effect
80
Epinephrine in **Neonatal Resuscitation**
- Indications
81
Epinephrine in **Neonatal Resuscitation**
- Adminstration
82
Compare between Routes of Adminstration of Epinephrine in Neonatal resuscitation in terms of:
- Concentration
- Route
- Dose
- Method
- Followed By
- Picture
83
Volume Expansion in **Neonatal Resuscitation**
- Indications
84
Volume Expansion in **Neonatal Resuscitation**
- Indications (Signs of shock)
- Pale color and
- Weak pulses
- Delayed capillary refill time
- Persistently low heart rate
85
Volume Expansion in **Neonatal Resuscitation**
- Indications (Hx of blood loss)
86
Criteria of volume expansion
- Type of Fluid
87
Criteria of volume expansion
- Dose
10 mL/kg
88
Criteria of volume expansion
- Route
Umbilical vein or intraosseous (peripheral IV is not recommended)
89
Criteria of volume expansion
- Preparation
Correct volume drawn into large syringe (30-60 ml)
90
Criteria of volume expansion
- Rate
Over 5 to 10 minutes
91
Criteria of volume expansion
- Precautions
92
What to do after neonatal resuscitation?
1. Routine Care
2. Post-natal care
3. Post-resuscitation care
93
What to do after neonatal resuscitation?
- Routine Care
94
What to do after neonatal resuscitation?
- Post-Resuscitation Care
95
When to stop resuscitation??
96
Resuscitation of preterm Newborn
- Additional Risks for preterm babies
97
Resuscitation of preterm Newborn
- Additional Resources in the Delivery Room
98
Resuscitation of preterm Newborn
- Additional Equipment Needed
99
Baby still not doing well after attempted resuscitation
- Where might the problem be?
100
Baby still not doing well after attempted resuscitation
- Does the baby fail to begin spontaneous respiration?
101
Baby still not doing well after attempted resuscitation
- Does PPV fail to result in adequate ventilation of the lung?
102
Baby still not doing well after attempted resuscitation
- Does the baby remain cyanotic or bradycardic despite good ventilation?
