Lesson 1: Neonatal Resuscitation

Question 1

Approximately ___% of newborns → some assistance to begin breathing at birth.

Answer 1

Approximately 10% of newborns → some assistance to begin breathing at birth.

Answer 2

< 1% → extensive resuscitative measures.

Question 3

What is the “Golden Minute” ?
Approximately _____ seconds (“the Golden Minute”) are allotted for completing the initial steps, reevaluating, and beginning ventilation if required

Answer 3

Approximately 60 seconds (“the Golden Minute”) are allotted for completing the initial steps, reevaluating, and beginning ventilation if required

Question 4

VLBW < _______g preterm babies → hypothermic ++

Answer 4

VLBW < 1500g preterm babies → hypothermic ++

Question 5

Temperature control

Prewarmingthedeliveryroomto__ºC

Answer 5

Temperature control

Prewarmingthedeliveryroomto26ºC

Question 6

Temperature control

Covering the baby in ______ wrapping

Answer 6

Temperature control

Covering the baby in plastic wrapping

Question 7

Temperature control

Placing the baby on an _______ mattress.
Placing the baby under ______ heat.
Placing the baby with the mother and covering both with a ______.

Answer 7

Temperature control
Placing the baby on an exothermic mattress.
Placing the baby under radiant heat
Placing the baby with the mother .and covering both with a blanket.

Question 8

+++ Monitoring closely the temperature ‘s baby to avoid the risk of ________.

Answer 8

+++ Monitoring closely the temperature ‘s baby to avoid the risk of hyperthermia.

Question 9

Amniotic fluid
Suctioningimmediatelyfollowingbirthshouldbereservedforbabies:

• have____________tospontaneousbreathingor
• whorequire___________.

Answer 9

Amniotic fluid
Suctioningimmediatelyfollowingbirthshouldbereservedforbabies:

• haveobviousobstructiontospontaneousbreathingor
• whorequirePPV(positivepressureventilation)

Question 10

When Meconium is present

performing ______suctioning of nonvigorous babies with meconium-stained amniotic fluid.

Answer 10

When Meconium is present

performing endotracheal suctioning of nonvigorous babies with meconium-stained amniotic fluid.

Question 11

Assessment of 02 need
1min:______

2min: _______
3min: ______

Answer 11

Assessment of 02 need
1min:60-65%

2min: 65-70%
3min: 70-75%

Question 12

Either ________ or _______oxygenation can be harmful to the baby

Answer 12

Either insufficient or excessive oxygenation can be harmful to the baby

Question 13

PulseOximetry

• Site:theprobeshouldbeattacheda______location(therightupperextremity:wristormedialsurfaceofthepalm).

Answer 13

PulseOximetry

• Site:theprobeshouldbeattachedapreductallocation(therightupperextremity:wristormedialsurfaceofthepalm).

Question 14

AdministrationofSupplementaryOxygen

• Neonatalresuscitationwith________
• Premature:resuscitationwith_________andair

Answer 14

AdministrationofSupplementaryOxygen

• Neonatalresuscitationwithroomair
• Premature:resuscitationwithblendof02andair

Question 15

Successful neonatal resuscitation required (4 points)
1.
2.
3.
4.

Answer 15

Successfulneonatalresuscitationrequired

• Anticipation,
• Adequatepreparation⭐
• Accurateevaluation
• Promptinitiationofsupport

Question 16

Drugs preparation (5 points)
1.
2.
3.
4.
5.

Answer 16

Drugspreparation

• Adrenaline/Epinephrine(1A=1/1000è)
• GlucoseSerum:5%-10%
• Dopamine(1Ade50mg)
• Serumphysiologic/RL/albumin4%.
• Surfactant

Question 17

At every delivery there should be at least 1 person capable of initiating resuscitation: (2 points)

1. Administrationof_______
2. ____

Answer 17

At every delivery there should be at least 1 person capable of initiating resuscitation: (2 points)
1. Administrationofpositivepressureventilation(PPV)
2.
Chestcompression

Question 18

skills required to perform a complete resuscitation (2 points)
1. E__________

2. Administrationof___________

Answer 18

skills required to perform a complete resuscitation (2 points)
1. Endotrachealintubation

2. Administrationofmedications

Question 19

Positive-Pressure Ventilation (PPV)
Indication

• If______or_______or
• ifHR

Answer 19

Positive-Pressure Ventilation (PPV)
Indication

• Ifapneicorgaspingor
• ifHR

Question 20

Positive-Pressure Ventilation (PPV)
Technique

• Rates:____to_____breaths/mn.
• Inflationpressure
  
  • Initialinflationpressureof_____cmH2Omaybeeffective
  • but≥____to____cmH2Omayberequiredinsometermbabieswithoutspontaneousventilation.

Answer 20

Positive-Pressure Ventilation (PPV)
Technique

• Rates:40to60breaths/mn.
• Inflationpressure
  
  • Initialinflationpressureof20cmH2Omaybeeffective
  • but≥30to40cmH2Omayberequiredinsometermbabieswithoutspontaneousventilation.

Question 21

Positive-Pressure Ventilation (PPV)
Efficacycriteria (5 points)

• Adequate______
• Symmetric__________,improvedpinkcolor,
• HR>____beats/min,
• ____________respirations
• _____________

Answer 21

Positive-Pressure Ventilation (PPV)
Efficacycriteria

• Adequatechestrise
• Symmetricbreathsounds,improvedpinkcolor,
• HR>100beats/min,
• Spontaneousrespirations
• Improvedtone

Question 22

Positive-Pressure Ventilation (PPV)
Contraindication
1.________hernia

2. ________amniotic

Answer 22

Positive-Pressure Ventilation (PPV)
Contraindication
1.Diaphragmatichernia

2. Meconiumfluidamniotic

Question 23

CPAP (Continuous Positive Airway Pressure)
Indication (2 points)

• preterm
• Infantswhoarebreathingspontaneously,butwithdifficulty,followingbirth

Answer 23

CPAP (Continuous Positive Airway Pressure)
Indication

• ________
• Infantswhoarebreathingspontaneously,but_________,followingbirth

Question 24

Endotracheal Tube Placement (Intubation)
Indication (4 points)
-Initial_____________ofnonvigorousmeconiumstainednewborns

• If___________isineffectiveorprolonged
• When_______________areperformed

●forspecialresuscitationcircumstances

• ________________
• ___________________

Answer 24

Endotracheal Tube Placement (Intubation)
Indication
-Initialendotrachealsuctioningofnonvigorousmeconiumstainednewborns

• Ifbag-maskventilationisineffectiveorprolonged
• Whenchestcompressionsareperformed

●forspecialresuscitationcircumstances

• congenitaldiaphragmatichernia
• ExtremelyLowBirthWeightInfant

Question 25

Chest Compressions Indication - HR

Answer 25

Chest Compressions Indication - HR

Question 26

Chest Compressions Technique - ______ of the sternum to a depth of approximately _____ of the anterior-posterior diameter of the chest. - _______ (Ratio 3:1)

Answer 26

Chest Compressions Technique - lower third of the sternum to a depth of approximately one third of the anterior-posterior diameter of the chest. - 2 thumb–encircling hands technique (Ratio 3:1)

Question 27

Chest Compressions Possible complications - _______, _________, myocardial _______ and ______ liver.

Answer 27

Chest Compressions Possible complications - Rib fracture, pneumothorax, myocardial contusion and laceration liver.

Question 28

Medications Epinephrine 1/_________ (0.1mg/ml) IV dose: _____-_____ mg/kg/dose (____-____ml/kg) Endotracheal dose :____-_____ mg/kg/dose The dose may be repeated every ____-_______min

Answer 28

Medications Epinephrine 1/10 000 (0.1mg/ml) IV dose: 0.01-0.03 mg/kg/dose (0.1-0.3ml/kg) Endotracheal dose :0.05-0.1 mg/kg/dose The dose may be repeated every 3-5 min

Question 29

Medications Epinephrine Indication - HR <60/mn despite adequate ventilation (usually with endotracheal intubation) with 100% oxygen and chest compressions, - Asystole Efficacy criteria - HR > ____________ beats/mn

Answer 29

Indication - HR <60/mn despite adequate ventilation (usually with endotracheal intubation) with 100% oxygen and chest compressions, - Asystole Efficacy criteria - HR > 100 beats/mn

Question 30

Volume expansion when _________ is known or suspected (pale skin, poor perfusion, weak pulse) and the ____________ adequately to other resuscitative measures. An isotonic crystalloid solution (serum physiologic Nacl 0.9%/LR/Albumine 4%) or blood _______ mL/kg, which may need to be repeated

Answer 30

Volume expansion when blood loss is known or suspected (pale skin, poor perfusion, weak pulse) and the baby’s heart rate has not responded adequately to other resuscitative measures. An isotonic crystalloid solution (serum physiologic Nacl 0.9%/LR/Albumine 4%) or blood 10 mL/kg, which may need to be repeated