Lesson 4 Flashcards
Is the 2 thumb technique for chest compressions recommended?
Yes, it’s the most effective
How much depth should the baby’s chest be compressed?
1/3 of its diameter
How many compressions are delivered per min?
90
After how many chest compressions do ventilations need delivered?
Every 3 compressions
How should the chest compression provider count out instructions to the ventilation provider?
One and two and three and breath and one …
How many ventilations should be given with every 90 compressions/ per min?
30
When can oxygen be delivered at 100% concentration?
When you start chest compressions
Once the heart rate increases above 60 bpm, pulse oximetry can be used to access _______ & _______
Blood oxygenation & titrate supplemental oxygen levels
If chest compressions are indicated there will likely be a need for continued _____ & insertion of invasive cord lines into _____
PPV & umbilical cord stalk
Once the ETT is placed by the PPV provider, that provider should then step to the side to allow room for
The person placing the umbilical Venus catheter
The 2 thumb technique is easier to provide in which 2 positions of the baby
The top by the head or the bottom by the feet
After 60 seconds of chest compressions what needs checked?
Heart rate
When can chest compressions be stopped?
Spontaneous heart rate reaches 60 bpm
If the heart rate does not recover after 60 secs of compressions
Access compression efforts
When is epinephrine indicated?
If heart rate does not recover after 30 effective PPV & 60 secs high quality compressions and ventilations
Who should administer epinephrine?
The other assistant that is not doing compressions or ventilations. That way the can administer epinephrine while continuing compressions and PPV
What’s the preferred route of administering epinephrine?
Through the umbilical vein catheter
Delivering epinephrine through the umbilical vein catheter reliably delivers the epinephrine to the
Central venous system
What’s intraosseous?
a procedure that involves inserting a needle into the bone marrow to inject fluids, medication, or blood products. It’s a non-collapsible alternative to intravenous access that’s used in life-threatening situations when other methods are not possible
What is the other acceptable way to administer epinephrine but less desirable way?
Intraosseous (bone marrow)
What’s a peripheral intravenous catheter? Where does it go?
a thin, flexible tube that is inserted into a vein to deliver fluids, medications, and other therapies
usually inserted into a vein in the lower arm or back of the hand, but can also be placed in the foot or scalp
Is a peripheral intravenous catheter recommended?
No, it should not even be attempted during a critical time.
Where can epinephrine be administered while a umbilical vein catheter is being placed?
Through the ETT
What is hard to predict when administering epinephrine through ETT?
The amount that reaches the bloodstream
True/False? ETT epinephrine is the last resort option of all 3 options to administer epinephrine
True
Once an IV access is available what can be administered again?
Epinephrine
1:10,000 dilution of epinephrine is equal to ___mg/ml
O.1
The IV / IO dose of epinephrine is _____ ml/kg
0.1 to 0.3 (1:10,000 = .01 - .03 mg/kg)
The dose of epinephrine when administered through ETT is higher than the IV IO dose @
.5 - 1 mL /kg
Epinephrine should be given quickly follow by a flush of _____ mL normal saline
0.5 - 1
How long does it take for IV IO epinephrine to take effect?
1 min
What’s the next step after administering epinephrine?
Continue chest compressions for 60 sec then check heart rate
After giving epinephrine and chest compressions for 60 sec, the heart rate is below 60 bpm, what the next step?
Continue chest compressions and ventilations
When should you start at the lower end of epinephrine dose rage?
For the initial dose, you can increase it with each dose a little
Since it’s unknown how much epinephrine gets into the blood stream through ETT administration and it seems ineffective can you administer more epinephrine to an available IV IO line, even if it hasn’t been a full 3 min?
Yes
What is a volume expander?
Crystalloid solutions (normal saline) or packed red blood cells
What is not a standard neonatal resuscitation pathway? (But something that can be used under certain circumstances )
Volume expanders
When is a volume expander indicated?
If effective PPV, chest compressions, and Iv IO epinephrine fail and neonate has signs of shock
What are the 7 indications for volume expanders?
Fetal maternal hemorrhage
Fetal trama
Placental laceration
Tight nuchal cord
Umbilical cord hemorrhage
Umbilical cord prolapse
Vasa previa hemorrhage
What is the fluid of choice for treating hypovolemia?
Normal saline
Define hypovolemia
A condition in which the liquid portion of the blood (plasma) is too low.
What fluid is used to treat severe anemia?
Packed red blood cells
What’s the initial dose of volume expander?
10 mL/kg
If the first dose of volume expander is ineffective can you give another full dose?
Yes
How long should it take to administer volume expanders?
5-10 min
What happens if you rapidly give a volume expander?
Can lead to intracranial hemorrhage
