50. Respiratory problems of newborns (resuscitation)

Question 1

what is the single most important and effective step in neonatal resuscitation?

Answer 1

Ventilation of the newborn’s lungs

Question 2

what is the best indicator of successful positive pressure ventilation (PPV)?

Answer 2

rising heart rate

Question 3

Ventilation corrective steps (MR. SOPA):

Answer 3

Mask adjustment
Reposition airway
Suction mouth and nose
Open mouth and lift the jaw
Pressure increase
Alternate airway (ETT/laryngeal mask)

Question 4

in what rate are chest compressions done?

Answer 4

3 chest compressions synchronized to 1 inflation

with 30 inflations per minute and 90 compressions per minute

Question 5

how are chest compressions done?

Answer 5

using the 2 thumb encircling hands technique

Question 6

how do we gain vascular access in a newly born during resuscitation?

Answer 6

the umbilical venous route is preferred
When intravenous access is not feasible –> intraosseous route may be considered.

Question 7

if the newly born not apneic or gasping, HR >100/min but has labored breathing or persistent cyanosis, what should be done?

Answer 7

1. position and clear airway
2. SPO2 monitor
3. supplementary O2–> consider CPAP
4. postresucitation care

Question 8

if the newly born is apneic or gasping, or HR <100/min what should be done?

Answer 8

1. PPV
   2.SP02 monitor
2. consider ECG monitor

*should be done in the first minute!

Question 9

is HR is still below 100/min after PPV?

Answer 9

1. check chest movements
2. ventilation corrective steps
3. ETT or laryngeal mask if needed

Question 10

HR <60/ min?

Answer 10

Resuscitation:
1. intubate
2. chest compressions (coordinate with PPV)
3. 100% 02
4. ECG
5. consider emergency umbilical vein catheterization (UVC)

Question 11

if HR is still <60/min what do we do?

Answer 11

IV epinephrine
still <60/ min–> hypovolemia? pneumothorax?