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Y4R1 - Pediatrics I 👶 > L2: Neonatal Resuscitation > Flashcards

L2: Neonatal Resuscitation Flashcards

1
Q

Causes of death in neonate

A
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2
Q

Percentage of babies that require resuscitation

A
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3
Q

Signs of compromised newborn

A
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4
Q

Mechanism & TTT of 1ry Apnea

A
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5
Q

Mechanism & TTT of 2ry Apnea

A
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6
Q

The Neonatal Resuscitation Program Flow Diagram

A
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7
Q

Risk factors predicting which babies will require resuscitation

A
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8
Q

Personnel that should be present at delivery

A
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9
Q

Questions that should you ask before every birth

A
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10
Q

Perform a pre-resuscitation team briefing

A
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11
Q

Indications of Delayed Cord clamping ‘’after 30 seconds’’

A

For both term and preterm infants who do not require resuscitation at birth

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12
Q

Benefits of Delayed Cord clamping ‘’after 30 seconds’’

A
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13
Q

Disadvantages of Delayed Cord clamping ‘’after 30 seconds’’

A

Higher mean serum bilirubin & use of phototherapy

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14
Q

All newborns require initial assessment to determine whether resuscitation is required immediately after birth

A
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15
Q

Initial Steps of Neonatal Resuscitation

A
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16
Q

Neonatal Resuscitation

  • Provide Warmth
A
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17
Q

Neonatal Resuscitation

  • Warming Methods
A
  • Placing newborn under radiant warmer
  • Drying thoroughly
  • Removing wet towels
  • Head cap
  • Plastic cover
  • Increase room temperature
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18
Q

Neonatal Resuscitation

  • Thermoregulation
A

Temperature of non-asphyxiated newborn infants be maintained between 36.5C & 37.5 after birth through resuscitation or stabilization

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19
Q

Neonatal Resuscitation

  • Warming Preterm Babies < 32 w GA
A
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20
Q

Neonatal Resuscitation

  • Opening the airway
A
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21
Q

Neonatal Resuscitation

  • Clear Airway = suction of secretions
A
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22
Q

Neonatal Resuscitation

  • Clear Airway = suction of secretions

(if no meconium)

A
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23
Q

Neonatal Resuscitation

  • Clear Airway = suction of secretions

(if meconium is present)

A
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24
Q

Neonatal Resuscitation

  • Tactile stimulation the baby to breathe or cry
A
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25
Q

Neonatal Resuscitation

  • Dry the baby
A

Dry thoroughly and remove wet linens

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26
Q

Neonatal Resuscitation

  • Initial Evaluation
A
  • Inspect chest rise = respiration (breathing or not)
  • Pulse oximetry = oxygen saturation (do not use color)
  • Stethoscope at the apex of the heart = HR in 6 sec multiplied by 10 to get HR in 1 min
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27
Q

You have approximately 30 sec to achieve a response before deciding to go on to the next step

A

…

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28
Q

Accepted Saturation in the 1st 10 minutes after birth

A
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29
Q

Assessment of breathing – HR – SaO2

  • 3 Scenariors
A
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30
Q

Golden Minute

A

Approximately 60 seconds (“the Golden Minute”) are allotted for completing the initial steps, revaluating, and beginning ventilation if required

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31
Q

Indications of PPV

A
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32
Q

……. is the single most important and most effective step in CPR of the compromised infant

A

Ventilation of the lungs

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33
Q

Concentration of Free Flow O2

A
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34
Q

Flow Rate in Free Flow O2

A

Adjust the flow meter to 10 L/min

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35
Q

Methods to adjust Free Flow O2

A
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36
Q

What to do after Free Flow O2?

A
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37
Q
  • Free-flow oxygen Cannot be given through the mask of a self-inflating bag; however, it may be given through the tail of an open reservoir
A

…

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38
Q

Methods of PPV

A
  • Self-inflating bag
  • Flow-inflating bag
  • T-piece resuscitator
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39
Q

Duration of PPV

A

15 sec

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40
Q

Rate & Technique of PPV

A
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41
Q

Pressure in PPV

A
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42
Q

Steps of initiating PPV

43
Q

How to place a resuscitation mask on the newborn’ s face?

44
Q

Compare between Flow Inflating Bag & Self Inflating Bag

45
Q

Compare between Flow Inflating Bag & Self Inflating Bag in terms of:

  • Filling
  • Compressed Gas Source
  • Delivered O2 Saturation
  • Inflation
  • Regulation of Pressure
  • Assessment of Pressure
  • Precautions
  • Picture
46
Q

Compare between Flow Inflating Bag & Self Inflating Bag in terms of:

  • Filling
  • Compressed Gas Source
  • Delivered O2 Saturation
  • Inflation
  • Regulation of Pressure
  • Assessment of Pressure
  • Precautions
  • Picture
47
Q

Compare between Flow Inflating Bag & Self Inflating Bag in terms of:

  • Filling
  • Compressed Gas Source
  • Delivered O2 Saturation
  • Inflation
  • Regulation of Pressure
  • Assessment of Pressure
  • Precautions
  • Picture
48
Q

Compare between Flow Inflating Bag & Self Inflating Bag in terms of:

  • Filling
  • Compressed Gas Source
  • Delivered O2 Saturation
  • Inflation
  • Regulation of Pressure
  • Assessment of Pressure
  • Precautions
  • Picture
49
Q

Compare between Flow Inflating Bag & Self Inflating Bag in terms of:

  • Filling
  • Compressed Gas Source
  • Delivered O2 Saturation
  • Inflation
  • Regulation of Pressure
  • Assessment of Pressure
  • Precautions
  • Picture
50
Q

Compare between Flow Inflating Bag & Self Inflating Bag in terms of:

  • Filling
  • Compressed Gas Source
  • Delivered O2 Saturation
  • Inflation
  • Regulation of Pressure
  • Assessment of Pressure
  • Precautions
  • Picture
51
Q

Compare between Flow Inflating Bag & Self Inflating Bag in terms of:

  • Filling
  • Compressed Gas Source
  • Delivered O2 Saturation
  • Inflation
  • Regulation of Pressure
  • Assessment of Pressure
  • Precautions
  • Picture
52
Q

Compare between Flow Inflating Bag & Self Inflating Bag in terms of:

  • Filling
  • Compressed Gas Source
  • Delivered O2 Saturation
  • Inflation
  • Regulation of Pressure
  • Assessment of Pressure
  • Precautions
  • Picture
53
Q

Self-inflated bag

54
Q

NEOPUFF TM Infant Resuscitator

55
Q

After 1st assessment (1st PPV Trial)

56
Q

After 1st PPV trial

  • if HR is increasing
57
Q

After 1st PPV trial

  • if HR is not increasing but chest is moving
58
Q

After 1st PPV trial

  • if HR is not increasing & chest is not moving
59
Q

Ventilation corrective steps (MR SOPA)

60
Q

Ventilation corrective steps (MR SOPA)

  • MR
A
  • Mask adjustment
  • Reposition the head to ensure an open airway
61
Q

Ventilation corrective steps (MR SOPA)

  • SOP
A
  • Suction the mouth and nose
  • Open baby’s mouth slightly and lift the jaw forward
  • Pressure Gradually / few breaths, (cautiously, & to a maximum of 40 cm H20), until there are bilateral breath sounds & visible chest movement
62
Q

Ventilation corrective steps (MR SOPA)

  • A
A
  • Airway alternative is considered (ET tube or laryngeal mask airway)
63
Q

Second Assessment of PPV

64
Q

Second Assessment of PPV

  • HR > 100
65
Q

Second Assessment of PPV

  • HR is 60-100
66
Q

Second Assessment of PPV

  • HR < 60
67
Q

Signs of effective ventilation

A
  1. increased Heart rate
  2. Improving muscle tone
  3. Improving color
  4. Spontaneous breathing
68
Q

Indications of ETT in neonatal resucitation

69
Q

Special Indications of ETT

70
Q

Indications of Chest Compression in neonatal Resuscitation

71
Q

Value of Chest Compression in neonatal Resuscitation

72
Q

Chest Compression in neonatal Resuscitation

  • Site of pressure & Depth
73
Q

Chest Compression in neonatal Resuscitation

  • Technique
74
Q

Chest Compression in neonatal Resuscitation

  • Steps
75
Q

Chest Compression in neonatal Resuscitation

  • Complications
A
  • Laceration of liver
  • Broken ribs
75
Q

Chest Compression in neonatal Resuscitation

  • Coordination of chest compression with ventilation
76
Q

Chest Compression in neonatal Resuscitation

  • If Heart Rate Remains < 60 bpm (after doing the previous)
77
Q

When to stop resuscitation?

78
Q

Meds in Neonatal Resuscitation

A
  • Epinephrine
  • Volume Expanders
79
Q

Epinephrine in Neonatal Resuscitation

  • Effect
80
Q

Epinephrine in Neonatal Resuscitation

  • Indications
81
Q

Epinephrine in Neonatal Resuscitation

  • Adminstration
82
Q

Compare between Routes of Adminstration of Epinephrine in Neonatal resuscitation in terms of:

  • Concentration
  • Route
  • Dose
  • Method
  • Followed By
  • Picture
83
Q

Volume Expansion in Neonatal Resuscitation

  • Indications
84
Q

Volume Expansion in Neonatal Resuscitation

  • Indications (Signs of shock)
A
  • Pale color and
  • Weak pulses
  • Delayed capillary refill time
  • Persistently low heart rate
85
Q

Volume Expansion in Neonatal Resuscitation

  • Indications (Hx of blood loss)
86
Q

Criteria of volume expansion

  • Type of Fluid
87
Q

Criteria of volume expansion

  • Dose
88
Q

Criteria of volume expansion

  • Route
A

Umbilical vein or intraosseous (peripheral IV is not recommended)

89
Q

Criteria of volume expansion

  • Preparation
A

Correct volume drawn into large syringe (30-60 ml)

90
Q

Criteria of volume expansion

  • Rate
A

Over 5 to 10 minutes

91
Q

Criteria of volume expansion

  • Precautions
92
Q

What to do after neonatal resuscitation?

A
  1. Routine Care
  2. Post-natal care
  3. Post-resuscitation care
93
Q

What to do after neonatal resuscitation?

  • Routine Care
94
Q

What to do after neonatal resuscitation?

  • Post-Resuscitation Care
95
Q

When to stop resuscitation??

96
Q

Resuscitation of preterm Newborn

  • Additional Risks for preterm babies
97
Q

Resuscitation of preterm Newborn

  • Additional Resources in the Delivery Room
98
Q

Resuscitation of preterm Newborn

  • Additional Equipment Needed
99
Q

Baby still not doing well after attempted resuscitation

  • Where might the problem be?
100
Q

Baby still not doing well after attempted resuscitation

  • Does the baby fail to begin spontaneous respiration?
101
Q

Baby still not doing well after attempted resuscitation

  • Does PPV fail to result in adequate ventilation of the lung?
102
Q

Baby still not doing well after attempted resuscitation

  • Does the baby remain cyanotic or bradycardic despite good ventilation?

Y4R1 - Pediatrics I 👶 (49 decks)

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