ACLS Flashcards
During the normal transition, the air that fills the baby’s lungs contains ____ % of oxygen.
21
If a neonate does not begin breathing even after stimulation, you should presume that the baby is in ____ and will require ____ .
Secondary apnea; PPV
What are the four pre-birth questions to be asked by the obstetric provider?
- What is the expected gestational age?
- Is the amniotic fluid clear?
- Are there any additional risk factors?
- What is our umbilical cord management plan?
What does the ABC of resuscitation stand for?
Airways (position and clear – suction only if necessary)
Breathing (after stimulation – consider spontaneous or assisted)
Circulation (assess heart rate and color)
First clean the ____ then the ____ when clearing the newborn’s airway.
Mouth; nose
What are the first steps in neonatal resuscitation?
- Warm and maintain normal temperature
- Position
- Clear airway
- Dry and stimulate if needed
In NRP, after initial rescuscitation, if the HR is below 100, or if the neonate demonstrates apnea or gasping, then the next step is ____ .
- PPV
- SpO2 monitor
- Consider EKG monitor
In NRP, after initial rescuscitation, if the neonate demonstrates labored breathing or persistent cyanosis (but not apnea or gasping), the next steps are ____ .
- Position and clear the airway
- SpO2 monitior
- Supplemental O2 as needed
- Consider CPAP
In NRP, after PPV has been initiated, if HR remains < 100 but > 60, the next steps are ____ .
- Check chest movement
- Ventilation corrective steps if needed
- ETT or laryngeal mask if needed
In NRP. after PPV has been initiated, if HR is < 60, the next steps are ____ .
- Intubate if not already done
- Chest compressions
- Coordindate with PPV
- 100% O2
- EKG monitor
- Consider emergency UVC
In NRP, after chest compressions have been initiated, if HR remains < 60, the next steps are ____ .
- IV epinephrine
During neonatal resuscitation, how often can IV epinephrine be repeated?
Every 3-5 minutes
What are the targeted preductal SpO2 sats after birth, by minute of life?
1 min - 60-65%
2 min - 65-70%
3 min - 70-75%
4 min - 75-80%
5 min - 80-85%
10 min - 85-95%
For NRP, what is the concentration of epinephrine to use?
0.1 mg/mL
For NRP, what is the suggested initial dose for IV/IO epinephrine?
0.02 mg/kg
(0.01 - 0.03 mg/kg)
During NRP, when should you recheck a heart rate after administration of IV/IO epinephrine?
60 seconds after administration
During NRP, what is the recommended ratio of compressions to ventilations, and at what speed?
3 compressions : 1 ventilation
This cycle takes place every 2 seconds.
During NRP, how do you determine the insertion depth of the ET tube?
NTL [nasal-tragus length] + 1 cm
If a baby’s condition suddenly worsens after intubation, what does the DOPE mnemonic stand for?
Dispalced endotracheal tube
Obstructed endotracheal tube
Pneumothorax
Equipment failure
During NRP, where do you place your thumbs for chest compressions? How far do you compress?
On the center of the sternum just below the nipple line.
Compress 1/3 the AP diameter of the chest.
During NRP, if administering a volume expander, what do you use? How much? Over what infusion duration?
Use NS, 10 mL/kg, over 5-10 minutes
During NRP, when placing an emergency UVC, how far do you insert the catheter?
3-4 cm, until free flow of blood is obtained when you open the stopcock and gently aspirate
In NRP, what are the steps of MR SOPA if ventilation is unsuccessful?
Mask adjustment
Reposition head/neck
– 5 breaths –
Suction mouth/nose
Open mouth
– 5 breaths –
Pressure increase
– 5 breaths –
Alternative airway
How do you measure the insertion depth of an OG tube?
Measure from the bridge of the nose to the earlobe, and from the earlobe to a point halfway between the xiphoid process and the umbilicus.
During NRP, as the heart rate increases over 100 and the baby begins to breathe, what are the next steps?
- Slow the rate of PPV
- Gently stimulate the baby
- Once the baby is breathing well enough to sustain a heart rate over 100, discontinue PPV
In NRP, if the baby weighs more than ____ , a laryngeal mask bay be used as an alternative airway to avoid delays in care.
2 kg
In NRP, what is the correct ET size (ID. or inner diameter) based on an infant’s weight?
< 1 kg - 2.5 mm
1-2 kg - 3.0 mm
> 2 kg - 3.5 mm
In NRP, what is the correct ET size (ID, or inner diameter) based on an infant’s gestational age?
< 28w - 2.5 mm
28-34w - 3.0 mm
> 34w - 3.5 mm
In NRP, what are the recommended PIP and PEEP?
PIP 20-25
PEEP 5
In NRP, what is the correct rate of PPV?
1 breath every 2-3 seconds
