Neonatal Life Support/Resus Flashcards
What is basic resus in neonate?
Up to Positive pressure ventilation
If needs more, like chest compressions, need advanced
Neonatal resuscitation Focus is?
Respiration
Ventilation
Fetal circulation
ductus Portal vein >IVC>RA>Ovale>LA>LV>systemic
Any blood that gets into RV and pulmonary artery passes into aorta via duct ductus arteriosus
Adaptation following birth in Resp?
Lung expands
Decreased PVR
More pulmonary blood flow
Systemic vascular resistance increases with clamping
Functional closure of ductus arteriosus via dramatic increase in pulmonary blood flow
3 things to ask when baby is born?
Term?
Breathing/crying
Good tone (flexed, not floppy/extended)
How to stimulate baby?
Flick toes
Rub chest
What to do at resus after initial assessment?
Maintain normal temp
Ensure open airway
Stimulate
HR in Neonatal resuscitation?
> 100/min
If HR is
Positive pressure
SP02 monitoring
Reassess after 30seconds
If all else fails in Neonatal resuscitation, what drugs?
Adrenaline
Volume expansion
O NEG blood
Colour in baby?
Not really reliable: use Sp02
Assess HR
110-160
Listen to via stethoscope
Can palpate cord for pulsation S
Signs of a compromised newborn
Not crying
Not breathing/gasping
Bradycardia:
What is open airway in Neonatal resuscitation ?
Neutral: 15-20degrees extension ‘sniffing position’
T-piece/Neopuff settings?
25 32 was
Good seal
Connect gas
RR: 40-60
When to ventilate a baby?
Brady
No breathing
O2 for resus? %?
> 32 weeks? Room air
When to intubate a neonate?
If HR
How to know successful intubation?
Improve HR CO2 detector (gold is good)
When bag mask ventilation not indicated?
diaphragmatic hernia
When give chest compressions in Neonatal resuscitation ? How much O2?
How much for effective chest compression?
1/3 of AP diameter
Most effective route for IV access in Neonatal resuscitation ?
Umbilical vein
How many events and breath/compressions in Neonatal resuscitation ?
120 events
30 breaths
90 compressions
1:3
When to use I/O in Neonatal resuscitation?
Fluid bolus
Adrenaline dose for Neonatal resuscitation?
0.1 - 0.3ml/kg 1:10,000
10x the dose if down endotracheal tube
Extra considerations for preterm baby Neonatal resuscitation ?
Increase ambient temp Poly there plastic bad Gentle handling Surfactant Senior medical staff
When discontinue Neonatal resuscitation ?
If no response after 10 minutes of maximal resus. No hard and fast rule.
Post resus care?
Monitoring: vitals
Engage family, debrief.
