Neonatal resus Flashcards
Causes of respiratory depression at birth
asphyxia immaturity maternal medications (analgesics, sedatives, general anaesthesia) sepsis
Initial steps of resus
Prevent heat loss, place on warmer, dry thoroughly, remove wet towel
Open the airway; position the infant; suction mouth and then nose
Initiate breathing, tactile stimulation
Evaluate infant breathing, heart rate and colour (use a logarithm)
If meconium is in amniotic fluid which is thick or particulate, the mouth and pharynx should be suctione
Hypotension causes
blood loss
inadequate fluid intake
sepsis
prolonged respiratory failure
Monitor vitals
heart rate, blood pressure, urine output, skin colour, capillary refilling time (normal less than two sec)
COMPONENTS OF APGAR SCORE
HEART RATE, RESIRATORY RATE, MUSCLE TONE, REFLEX IRRITABILITY (to stimulation), COLOUR.
During stabilisation, deal with complications such as
– Hypothermia, – Hypoxaemia, – Hypotension & poor perfusion, – Acidosis, – Hypoglycaemia, – Fluid & electrolyte balance
STABLE
Sugar Temp Airway, acid-base Blood pressure Labs Educate + emotional support to family
If a neonate deteriorates suddenly, assume
airway compromise until ruled out
if resp distress, order
Xray
Common Airway Complications - DOPE
- Displaced endotracheal tube
- Obstructed endotracheal tube
- Pneumothorax
- Equipment failure
Causes of shock
• Blood loss • Respiratory failure • Inadequate fluids / dehydration • Sepsis • Heart disease – Congenital heart disease, myocardial dysfunction
Consider starting what drugs
- Antibiotics
- Inotropes
- Surfactant
- Opiate sedation
- Prostin - keep PDA
