Newborn / neonate Resuscitation

Question 1

Newborn / Neonate Resuscitation - Initially presents with good tone, respiration or crying?

Answer 1

Routine care and transport to L & D

Question 2

Newborn / Neonate Resuscitation - < 28 weeks and initially presents with apnea , weak cry, poor respiratory effort, poor tone or HR < 100 bpm?

Answer 2

Do not dry baby
Place in food grade plastic bag and cover head except for face
Position airway
Suction if required

Question 3

Newborn / Neonate Resuscitation - > 28 weeks and initially presents with apnea , weak cry, poor respiratory effort, poor tone or HR < 100 bpm?

Answer 3

Warm and dry
Position airway
Suction as needed

Question 4

Newborn / Neonate Resuscitation - Flat neonate after warming and stimulation Hr > 100 & breathing?

Answer 4

Routine care

Question 5

Newborn / Neonate Resuscitation - Flat neonate after warming and stimulation Hr < 100 & not breathing?

Answer 5

PPV with room air @ 40-60 bpm

SpO2 and targeted sats

Question 6

Newborn / Neonate Resuscitation - Flat neonate unresponsive to PPV for 1 min and HR < 60 bpm ?

Answer 6

Ensure adequate ventilation
Consider LMA
Chest compressions with PPV & 100% O2 @ 3:1 ratio

Question 7

Newborn / Neonate Resuscitation - HR > 60 after 1 min of CPR?

Answer 7

Provide PPV until HR > 100bpm

Question 8

Newborn / Neonate Resuscitation - HR < 60 after 1 min of CPR?

Answer 8

Epi 0.01 mg/kg IO q 3-5 until HR > 60

Question 9

Newborn / Neonate Resuscitation - Tube side for < 28 weeks?

Answer 9

2.5

Question 10

Newborn / Neonate Resuscitation - Tube size 28 – 34 weeks

Answer 10

3.0

Question 11

Newborn / Neonate Resuscitation - Tube size 34 – 38 weeks

Answer 11

3.5

Question 12

Newborn / Neonate Resuscitation - Tube size > 38 weeks?

Answer 12

3.5 - 4.0

Question 13

Newborn / Neonate Resuscitation - Apgar - A

Answer 13

Appearance
0 - Blue or pale all over
1 - Blue extremities / pink body (acrocyanosis)
2 - Pink body and pink extremities, no cyanosis

Question 14

Newborn / Neonate Resuscitation - Apgar - P

Answer 14

Pulse
0 - Absent
1 - Less than 100
2 - Greater than or equal to100

Question 15

Newborn / Neonate Resuscitation - Apgar - G

Answer 15

Grimace
0 - No response to stimulation
1 - Grimace / feeble cry when stimulated
2 - Cry or pull away when stimulated

Question 16

Newborn / Neonate Resuscitation - Apgar - A

Answer 16

Activity
0 - None
1 - Some flexion
2 - Flexed arms and legs that resist extension

Question 17

Newborn / Neonate Resuscitation - Apgar - R

Answer 17

Respiration
0 - Absent
1 - Weak, irregular, gasping
2 - Strong cry

Question 18

Newborn / Neonate Resuscitation - Epinephrine indication

Answer 18

Bradycardia less than 60 bpm unresponsive to stimulation, oxygenation, ventilation, and chest compressions
Cardiac arrest

Question 19

Newborn / Neonate Resuscitation - Epinephrine dose

Answer 19

0.01 mg/kg IO (rapidly follow with up to a 5 mL normal saline flush) q 3 – 5 minutes prn until heart rate greater than 60 bpm

Question 20

Newborn / Neonate Resuscitation - Epinephrine EMS contraindications

Answer 20

None when used in emergency situations

Question 21

Newborn / Neonate Resuscitation - Naloxone indications

Answer 21

Mother received narcotics within 4 hours of delivery & presents with respiratory depression

Question 22

Newborn / Neonate Resuscitation - Naloxone dose

Answer 22

0.1 mg/kg IM

Do not repeat dose

Question 23

Newborn / Neonate Resuscitation - Naloxone EMS contraindications

Answer 23

Newborn of a mother who is suspected of being addicted to narcotics or is on methadone maintenance

Question 24

Newborn / Neonate Resuscitation - Naloxone precautions

Answer 24

Naloxone is not the first corrective therapy for a baby who is not breathing; the first action is positive-pressure ventilation