Neonatal resus Flashcards
Which babies are unlikely to require resuscitation?
- > 37 weeks gestational age
- Amniotic fluid clear of meconium and evidence of infection
- Baby is breathing and crying normally
- Baby has good muscle tone
What is the first thing you do to manage a very low birth weight baby (<1500g), straight after birth?
Cover in plastic wrap/bag immediately to prevent heat loss (everything else can be done with the baby covered in plastic)
Ensure the baby’s airway and head aren’t covered
What are the major drawbacks of deep, vigorous suctioning of a neonate?
- Bradycardia due to vagus nerve stimulation
- Laryngospasm
When does a baby need resuscitation?
If any one of the following three are present:
- Not breathing adequately
- Heart rate < 100 bpm
- Poor muscle tone
How frequently should you re-assess the heart rate and respiration of a baby that you are resuscitating?
Every 30 seconds
What are the components of the Apgar score?
A - Appearance/complexion P - Pulse G - Grimace A - Activity R - Respiration
What is considered a “normal” Apgar score?
> 7
Who is naloxone given to?
Baby whose mother received narcotic analgesic within 4 hour of delivery
Dose of naloxone
0.1mg/kg (0.25ml/kg) IM or IV
May need to be repeated after 2 hours to avoid apnoeic spells
When to stop chest compressions
HR over 60/min
Depth of compression
1/3 depth
Reasons for poor chest rise during ventilation
Mask seal Obstruction Ventilate more firmly Intubation needed? Nasal choanal atresia Gastric distension
ET tube sizes per weight
3000 - 3.5-4.0
Insertion depth for ET tube
Weight in kg + 6cm
How long to attempt intubation
20s
Baby fail to improve after ET tube inserted. Cause?
Displaced/ dislodged tube Obstruction Pneumothorax Equipment failure Stomach distension
Dose of bicarbonate if given
2mls of 4.5%/kg IV over 2 mins
If saline needed to increase blood volume, what dose?
10ml/kg via umbilical venous line over several mins
Glucose dosage to in neonate
2-4ml 10% dextrose per kg
If below 1.5 give 10% des at 60ml/kg/day
Normal 02 seats after birth
1 min >60% 2 mins >65% 3 mins >70% 4 mins >75% 5 mins >80% 10 and above 85-95%
