Murat Flashcards
What percentage of newborns require assistance after birth?
Approximately 10% require assistance after birth
Only 1% need major resuscitative measures.
What are the significant physiological changes during the transition from intrauterine to extrauterine life?
- Lungs transition from fluid-filled to air-filled
- Pulmonary blood flow increases
- Blood oxygen levels rise
What can lead to sustained constriction of pulmonary arterioles in newborns?
Failure to establish adequate ventilation
This can lead to inadequate oxygenation of blood and potential organ damage, especially to the brain.
List clinical signs of transition abnormalities in newborns.
- Depressed respiratory drive
- Bradycardia
- Hypotension
- Cyanosis
- Poor muscle tone
What is primary apnea in newborns?
Occurs in response to hypoxia and is usually reversible with stimulation
What is secondary apnea in newborns?
Occurs if hypoxia persists and requires positive-pressure ventilation (PPV)
What is the crucial preparation needed for resuscitation at every delivery?
- A designated individual skilled in resuscitation should be present
- Equipment must be prepared and checked, including a radiant warmer
What immediate steps should be taken after birth?
- Thorough drying to stimulate breathing and prevent hypothermia
- Hypothermia can lead to complications such as infection, coagulation defects, and brain hemorrhage
How can stimulation be provided to infants with depressed respiratory effort?
Flicking the soles of the feet or rubbing the back
What is the recommended oxygen administration for infants ≥ 35 weeks gestational age?
Initiate resuscitation with room air (21% oxygen)
When should suctioning be performed on infants?
Only suction infants with airway obstruction or those requiring positive-pressure ventilation (PPV)
How should an infant be positioned to open the airway?
Position the infant with a slightly extended neck
What are the indications for positive-pressure ventilation (PPV)?
- Apnea
- Heart rate < 100 bpm
- No improvement in oxygen saturation
What should be monitored during chest compressions in newborns?
Monitor heart rate every 15 seconds
What is the compression:ventilation ratio during neonatal resuscitation?
3:1 (90 compressions and 30 breaths per minute)
When should epinephrine be administered during resuscitation?
If bradycardia (< 60 bpm) persists despite one minute of adequate ventilation and chest compressions
What volume of saline should be given for volume expansion in infants with pallor and poor perfusion?
10 mL/kg of 0.9% saline IV over 5-10 minutes
What should be done if pneumothorax is suspected in a newborn?
Perform needle thoracocentesis to aspirate air
What is the recommendation regarding meconium-stained amniotic fluid for vigorous infants?
Routine suctioning is not beneficial
After how many minutes of absent heart rate should resuscitation efforts be considered for termination?
After 10 minutes
What is the recommended timing for delayed cord clamping (DCC)?
Wait at least 30-60 seconds before clamping the cord
What is umbilical cord milking (UCM)?
Involves quickly ‘stripping’ blood from the cord within 20 seconds
What does the Apgar score assess?
- Appearance (skin color)
- Pulse (heart rate)
- Grimace (reflex irritability)
- Activity (muscle tone)
- Respiration
What should be done if a 5-minute Apgar score is < 7?
Repeat assessments every 5 minutes up to 20 minutes
What terminology should be avoided in neonatal resuscitation?
Avoid using ‘birth asphyxia’
What term should be used instead of ‘birth asphyxia’?
‘Perinatal Hypoxia and Ischemia’
True or False: A low 1st-minute Apgar score (<=3) predicts morbidity.
False
