Neonatal Life Support/Resus

Question 1

What is basic resus in neonate?

Answer 1

Up to Positive pressure ventilation

If needs more, like chest compressions, need advanced

Question 2

Neonatal resuscitation Focus is?

Answer 2

Respiration

Ventilation

Question 3

Fetal circulation

Answer 3

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

Question 4

Adaptation following birth in Resp?

Answer 4

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

Question 5

3 things to ask when baby is born?

Answer 5

Term?
Breathing/crying
Good tone (flexed, not floppy/extended)

Question 6

How to stimulate baby?

Answer 6

Flick toes

Rub chest

Question 7

What to do at resus after initial assessment?

Answer 7

Maintain normal temp
Ensure open airway
Stimulate

Question 8

HR in Neonatal resuscitation?

Answer 8

> 100/min

Question 9

If HR is

Answer 9

Positive pressure
SP02 monitoring

Reassess after 30seconds

Question 10

If all else fails in Neonatal resuscitation, what drugs?

Answer 10

Adrenaline
Volume expansion
O NEG blood

Question 11

Colour in baby?

Answer 11

Not really reliable: use Sp02

Question 12

Assess HR

Answer 12

110-160
Listen to via stethoscope
Can palpate cord for pulsation S

Question 13

Signs of a compromised newborn

Answer 13

Not crying
Not breathing/gasping
Bradycardia:

Question 14

What is open airway in Neonatal resuscitation ?

Answer 14

Neutral: 15-20degrees extension ‘sniffing position’

Question 15

T-piece/Neopuff settings?

Answer 15

25 32 was
Good seal
Connect gas
RR: 40-60

Question 16

When to ventilate a baby?

Answer 16

Brady

No breathing

Question 17

O2 for resus? %?

Answer 17

> 32 weeks? Room air

Question 18

When to intubate a neonate?

Answer 18

If HR

Question 19

How to know successful intubation?

Answer 19

Improve HR
CO2 detector (gold is good)

Question 20

When bag mask ventilation not indicated?

Answer 20

diaphragmatic hernia

Question 21

When give chest compressions in Neonatal resuscitation ? How much O2?

Question 22

How much for effective chest compression?

Answer 22

1/3 of AP diameter

Question 23

Most effective route for IV access in Neonatal resuscitation ?

Answer 23

Umbilical vein

Question 24

How many events and breath/compressions in Neonatal resuscitation ?

Answer 24

120 events
30 breaths
90 compressions
1:3

Question 25

When to use I/O in Neonatal resuscitation?

Answer 25

Fluid bolus

Question 26

Adrenaline dose for Neonatal resuscitation?

Answer 26

0.1 - 0.3ml/kg 1:10,000

10x the dose if down endotracheal tube

Question 27

Extra considerations for preterm baby Neonatal resuscitation ?

Answer 27

Increase ambient temp
Poly there plastic bad
Gentle handling
Surfactant
Senior medical staff

Question 28

When discontinue Neonatal resuscitation ?

Answer 28

If no response after 10 minutes of maximal resus. No hard and fast rule.

Question 29

Post resus care?

Answer 29

Monitoring: vitals

Engage family, debrief.