Key Points Flashcards
Identify Risk Facators
(1) what is the expected gestational age? (2) is the amniotic fluid clear? (3) are there any additional RFs? (4) What is our umbilical cord management plan?
Rapid evaluation
Term? Tone? Breathing/crying?
Initial 5 steps
(1) Provide warmth (2) Dry (3) stimulate (4) position head and neck (5) clear secretions
when to apply pulse ox
(1) when resuscitation is anticipated (2) to confirm persistent suspected central cyanosis (3) if giving supplemental oxygen (4) PPV
Oxygen saturation
should be 85-95% by 10 minutes
After 1st minute
PPV if no breathing, gasping, apneic or limp
O2 flow saturation
For term NB - start at 30% at 10L/min
To give PPV
(1) set flow meter to 10L/min (2) Rate 40-60 bpm (3) inflation pressure 20-25 cm (4) for term NB begin with 21% O2 (5) initial PEEP is 5cm
Corrective measures (*Mr SOPA) - if HR isn’t increasing and Chest movement isn’t observed (15 seconds)
Mask - Reposition - Suction - Open mouth - Pressure increase - Alternative airway
After 30 seconds of effective PPV and HR < 60
Reassess ventiliation techniques, adjust FIO2 with pulse oximetry, insert alternate airway for 30 seconds; if HR still < 60, increase FIO2 to 100% and start chest compressions
when to insert orogastic tube
with PPV or CPAP after a few minutes
how to measure orogastric tube
bridge of nose - earlobe - halfway between xiphoid process and umbilicus
when to insert ET
HR < 100 and is not increasing after PPV; is strongly recommended before starting chest compressions; for direct tracheal suction of the trachea is obstructed by thick secretions
Laryngoscope blade sizes
Term NB - size 1; Preterm - size 0; Intube in 30 seconds
Size selection of ET tubes
> 34 weeks (3.5mm) 28-34 (3.0mm) < 2.5 mm
