Newborn: Routine Care and Resuscitation Flashcards Preview

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Flashcards in Newborn: Routine Care and Resuscitation Deck (18):
1

What are the characteristics of a newborn requiring no additional resuscitation?

4 characteristics:
-1. A term infant
-2. Clear amniotic fluid with no evidence of meconium and infection
-3. Spontaneous breathing and crying
-4. Good muscle tone

2

What is the APGAR system?

Objective means to assess newborn condition.
- 5 signs
- scored 0 / 1 / 2 at
- 1 and 5 mins (and every 5 mins until 20 if under 7)

3

What are the signs assessed by APGAR?

- Appearance
- Pulse
- Grimace
- Activity
- Respiration

4

What is indicated by different APGAR scores?

-Apgar 7-10 = infant who requires no active resuscitation
-Apgar 4 - 7 = mild to moderately depressed infant
-Apgar <4 = severely depressed infant requiring immediate resuscitative efforts

5

What are the components of routine care of the newborn?

-1. Body temp
-2. Umbilical cord
-3. Vital signs
-4. Mother contact

6

How is newborn body temp maintained?

- thoroughly dry
- warm blankets
- skin to skin contact
- heater
If pre term:
- warming pads
- radiant heater

7

What is transitional care ?

Continued close observation for stabilisation - transition period (6-12h after birth).
- Prophylactic erythromycin or tetracycline to both eyes to prevent gonococcal ophthalmia neonatorum
- Vitamin K
- Monitor voiding pattern and bowel motions

8

What are the signs of a compromised newborn?

- Not crying
- Not breathing or gasping
- Very floppy
- Bradycardia
- Persisting cyanosis

9

What stimulates closure of ductus arteriosus?

- increase in systemic vascular resistance
- decreased pulmonary vascular resistance
= functional closure of DA

10

Describe use of the Neopuff.

-1. Check gas connected
-2. Use flow rate 10L / min
-3. Set pressures (25 <36w; 30 >36w)
-4. Ensure there is good seal
-5. Ventilate lungs at 40 - 60 breaths / min
-6. Ensure chest wall and upper abdomen moves with each inflation

11

What is required if no detectable heart beat?

Asap intubation

12

Causes of failure to response post intubation?

- Tube in oesophagus
- Tube too far
- Malfunction
- Pneumothorax
- Effusion
- Diaphragmatic hernia

13

Chest compressions or ventilation more important in neonatal resus?

Ventilation

14

Describe chest compressions in neonatal resus?

- Pressure to lower half sternum, keep in midline, avoid xyphoid process.
- Compress 1/3 AP diameter chest
- Avoid simultaneous compression / inflation

15

How may adrenaline be administered to newborn?

- Umbilical vein most rapidly accessible route for fluid and medication administration
- Endotracheal tube (if adrenaline: much larger doses required than standard)
- Peripheral IV line
- Intraosseous access
- Intramuscular

16

When is newborn resuscitation discontinued?

No response with measurable HR after 10 mins

17

Equipment required for anticipated newborn resus?

-1. Radiant warmer on
-2. O2 source open and adequate flow
-3. Suction tested
-4. Laryngoscope functional and light checked
-5. Bag and mask shows adequate seal and pressure

18

What are the broad steps of neonatal resuscitation for infant with HR below 60bpm?

- Warm, stimulate, suction, position
- PPV
- ETT or laryngeal if needed
- Intubate if not already
- Chest compressions
- IV adrenline