Lecture 2 - Neonatal Resuscitation Flashcards

1
Q

Where does resuscitation start for neonatal resuscitation?

A

In Utero

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2
Q

When fetal heart rate decreases it indicates:

A

Asphyxia

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3
Q

Short term variability of the fetus means:

A
  • 3-6 bpm

- CNS depressants reduce this short term variability

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4
Q

Long term variability of the fetus means:

A

Characterized by periodic accelerations correlating with fetal movements normally 15-40 accelerations per hour. Decreases seen with fetal sleep.

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5
Q

An absence of of short and long term variability may indicate:

A

fetal distress

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6
Q

Early deceleration patterns means:

A

-Vagal response to head compression, not associated with distress

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7
Q

Late deceleration paterns means:

A
  • Uteroplacental insufficiency

- Decreased O2 supply, combined with lack of short term variability is ominous for fetal distress

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8
Q

Variable deceleration patterns means:

A

-Related to cord compression
-Associated with fetal asphyxia when they are:
*> 70 bpm
*longer than 60 sec or
*occur in a pattern persisting for more than 30
minutes

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9
Q

What is a normal pH of a fetus?

A

7.25 - 7.35

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10
Q

A pH of < 7.20 for a fetus means:

A

Depressed neonate

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11
Q

How do you correct a FETUS in distress?

A

-Avoid and treat aortocaval compression
-correct hypotension
-Correct hypoxia
-Failure to remedy the situation calls for immediate
delivery

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12
Q

What are the main components of a neonatal assessment?

A
  • Fetal heart Rate monitoring
  • Apgar scores
  • Fetal cord pH
  • CPR
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13
Q

What categories does the apgar score upon?

A
  • Activity
  • Pulse
  • Grimace
  • Appearance
  • Respiration
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14
Q

Each category is scored differently in the apgar. What are the characterization of a ZERO.

A
  • Flaccid (Activity)
  • Absent (Pulse)
  • No Response (Grimace)
  • Pale/Blue (Appearance)
  • Absent (Respiration)
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15
Q

Each category is scored differently in the apgar. What are the characterization of a ONE.

A
  • Some flexion (Activity)
  • < 100 (Pulse)
  • Grimace (Grimace)
  • Blue Extremities (Appearance)
  • Weak (Respiration)
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16
Q

Each category is scored differently in the apgar. What are the characterization of a TWO.

A
  • Well Flexed (Activity)
  • > 100 (Pulse)
  • Cough/sneeze (Grimace)
  • Completely pink (Appearance)
  • Good cry (Respiration)
17
Q

Who is responsible for resuscitation of the neonate?

A

Neonatal care team

18
Q

T/F: Anesthesia’s primary responsibility is the mother.

A

TRUE

19
Q

If the HR is <60 or 60-80 and not rising what should be done for the neonate?

A
  • Chest compressions

- ETT

20
Q

T/F: It is not critical to keep a neonate warm.

A

FALSE

21
Q

How do you know the correct ETT size for a neonate?

A

Leak at 20 cm H2O

22
Q

When are the apgar scores usually done?

A
  • 1 minute after birth

- 5 minute after birth

23
Q

If the 5 minute score is less than __, repeat Apgar assessment every __ minutes until ___ minutes have passed or two successive scores are greater or equal to __.

A

7
5
20
7

24
Q

How much fluid can be given to a neonate with low B/P?

A

10 cc/kg

25
Q

What should be ruled out as causes of low B/P?

A

hypoglycemia
hypermagnesemia
hypocalcemia

26
Q

What is the dose of EPINEPHRINE:

A

0.01-0.03 mg/kg (ETT administered with 1 cc)

27
Q

What is the dose of Naloxone:

A
  • 0.1 mg/kg IV or ETT

- 0.2 mg/kg IM

28
Q

What is the dose for SODIUM BICARBINATE:

A

2 meq/kg IV over 2 minutes.

29
Q

T/F: Increased doses are typically recommended for ETT route in pediatric resuscitation, but NOT recommended for neonatal resuscitation.

A

TRUE