Neonatal Emergencies

Question 1

Initial stabilization of newborn

Answer 1

Warming- towels clean and wrap
Position- sniffing, towel roll
Suction- nose mouth
Stimulation- drying off, slapping g soles of feet, rubbing back gently or trunk

Question 2

Prefers baby

Answer 2

Born less than 37 weeks

Question 3

Suction

Answer 3

5-10FR
Suction mouth and then nose when born
Set suction on 100mmHg

Question 4

Position

Answer 4

When born, hold held slightly lower than body to facilitate drainage of mucus and secretions

Question 5

APGAR

Answer 5

1min and 5min After birth.

Question 6

Algorithm for Resuscitation

Answer 6

Suctioning, drying, stimulating, and positing for 30 seconds after birth.
30sec-60sec: HR<100 or apneuistic? Ventilate and Spo2
60sec-90sec: HR<100
Ensure correct ventilation and consider pneumothorax
90sec: HR<60?
CPR 3:1
Epinephrine

Question 7

Acrocyanosis

Answer 7

Blue feet and hands but pink trunk, normal

Question 8

BVM with neonate

Answer 8

Start with room air and then add oxygen if needed

Question 9

CPR

Answer 9

HR<60
3:1 ratio
Wait 60 seconds to check rhythm

Question 10

Free-Flow Oxygen

Answer 10

5L/min NRB of blow by if PPV is not indicated

Question 11

Oral Airway

Answer 11

Usually not needed but can be placed and provide proper airway for patient due to birth abnormalities
As with small children, use tounge blade to depress tounge and insert OPA as is

Question 12

Ventilate

Answer 12

Count “breath, two three, breath, two three”

Question 13

Intubation of newborn indications

Answer 13

Mecoomium staining presents and newborn is not vigorous 
No response to BVM
Prolonged PPV
Craniofacial Defects impede PPV
Advance 6-7cm at lip
Limit attempt to 20 sec

Question 14

Bradycardia

Answer 14

Epinephrine given after 30 seconds of ventilation and 30 seconds of compressions
Check rate after one minute

Question 15

Low Blood volume

Answer 15

10ml/kg

Question 16

Narcan

Answer 16

.1mg/kg

Question 17

Hypoglycemia

Answer 17

<40mg/dl administer D10 IV bolus of 2ml/kg

Question 18

Pneumothorax

Answer 18

Second intercostal
Midclavicular
22GA attached to syringe. If fills with air, push out air from syringe and continue to withdraw air

Question 19

Oxygen saturation

Answer 19

Normal to be around 60% for first minute and should come around after 10 minutes to 90%

Question 20

Seizures

Answer 20

Hypoglycemia, hypoxia, hypocalcemia

Ativan administered IV or rectal

Question 21

Fever

Answer 21

> 100.4 F rectal
Oral and axiallry about .6-1.2 degrees lower than rectal
Give antipyretic (Tylenol) 15mg/kg rectally

Question 22

Hypothermia

Answer 22

<95 F

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