CH1: Foundations of Neonatal Resuscitation

Question 1

Pre-ductal SpO₂ target at:

1 minute

2 minutes

3 minutes

4 minutes

5 minutes

10 minutes

Answer 1

60% - 65%

65% - 70%

70% - 75%

75% - 80%

80% - 85%

85% - 95%

Question 2

What happens when the baby breathes, the umbilical cord is clamped and the placenta is separated from the baby?

Answer 2

The newborn uses the lungs, instead of the placenta, for gas exchange

Question 3

What change occurs at birth when fluid in the alveoli is absorbed?

Answer 3

Air replaces fluid in the alveoli. Oxygen moves from the alveoli into the pulmonary blood vessels and the CO₂ moves into the alveoli to be exhaled.

Question 4

What change occurs at birth when the air in the alveoli causes blood vessels in the lung to dilate.

Answer 4

Pulmonary blood flow increases and the ductus arteriosus gradually constricts

Question 5

On average, how many minutes would it take for a normal newborn to achieve oxygen saturation >90%?

Answer 5

10 minutes

Question 6

Before birth, the alveoli in the fetal lungs are __1___ and filled with __2__.

Answer 6

1. Expanded
2. Fluid

Question 7

After birth, air in the alveoli causes vessels in the baby’s lungs to ______

Answer 7

Constrict

Question 8

List the clinical findings associated with the abnormal transition of fetal circulation.

Answer 8

1. Irregular or absent respiratory effort (apnea) or rapid breathing (tachypnea)
2. Slow heart rate (bradycardia) or rapid heart rate (tachycardia)
3. Decreased muscle tone
4. Low oxygen saturation
5. Low blood pressure

Question 9

What are the 5 major blocks in the NRP?

Answer 9

1. Initial assessment: determine if the newborn can remain with the mother or should be moved to a radiant warmer for further evaluation
2. Airway (A): Perform the initial steps to establish an open Airway and support spontaneous respiration
3. Breathing (B): Positive-pressure ventilation is provided to assist Breathing for babies with apnea or bradycardia. Other interventions (CPAP or oxygen) may be appropriate if the baby has labored breathing or low oxygen saturation.
4. Circulation (C): If severe bradycardia persists despite assisted ventilation, Circulation is supported by performing chest compressions coordinated with PPV.
5. Drug (D): If severe bradycardia persists despite assisted ventilation and coordinated compressions, the Drug epinephrine is administered as chest compressions continue.

Question 10

List the components of pre-resuscitation team briefing in the NRP?

Answer 10

1. Assess perinatal risk factors
2. Identify a team leader
3. Delegate tasks
4. Identify who will document the events as they occur
5. Determine what supplies and equipment will be needed
6. Identify how to call for additional help

Question 11

Elements of good communication skills of an effective team leader

Answer 11

1. Giving clear directions to specific individuals
2. Sharing information
3. Delegating responsibilities to ensure coordinated care
4. Maintaining professional environment

Question 12

What is situational awareness?

Answer 12

Being aware of the entire clinical situation and not get distracted by a single activity.

Question 13

Should the recorder also have other roles? Why?

Answer 13

No. Because this can disrupt observation and communication. An experienced team member needs to take this role in order to help the team leader.

Question 14

How do you maintain professional behavior?

Answer 14

1. Use respectful verbal and non-verbal communication
2. Actively seek and offer assistance
3. Support and promote teamwork
4. Respect and value your team