neonatal resus Flashcards
initial management of baby when born
Place the baby skin to skin with the mother.
Provide external stimulation while drying the baby.
Maximise the external temperature and place a hat on the baby if possible.
Continue to provide stimulation via rubbing/drying if breathing or activity is abnormal.
Establish continual heart rate and SpO2 monitoring if breathing or activity remain abnormal.
Move to the appropriate section below at approximately one minute.
If breathing is adequate and the heart rate is greater than or equal to 100/minute
Do not provide ventilation.
Clamp and cut the cord at 2-3 minutes.
Move to the appropriate section if there is
a sustained change in heart rate.
Administer oxygen only if required to maintain a normal SpO2
If breathing is inadequate or the heart rate is 60-100/minute
Clamp and cut the cord immediately if this is required to enable ventilation.
Ventilate at a rate of 60/minute, using PEEP set to 5 cmH2O, initially without added oxygen.
if the HR is 60-100, but fails to increase after two minutes…
Continue to ventilate and add oxygen at 10
litres/minute if the heart rate fails to rise above 100/minute after two minutes.
If the heart rate is less than 60/minute
Clamp and cut the cord immediately if this is required to enable CPR.
Start CPR at a ratio of 3:1. with OPA/IGEl
Focus on ventilation with PEEP set to 5 cmH2O and added oxygen at 10 litres/minute.
IV adrenaline dose for G less then or equal to 26 weeks
0.01 mg (0.1 ml of 1:10,000) for gestation less than or equal to 26 weeks.
adrenaline dose for full term (38 week) baby
0.05 mg (0.5 ml of 1:10,000) for gestation greater than or equal to 38 weeks.
expected Sp02 for baby post birth
normally begins at 60-65%, can take up too 10 minutes to come up to normal limits, would expect it to continuously increase
threshold to treat hypoglycaemia in neonate
2.5 mmol
when should IV glucose be administered in a neonate
Administer 10 ml of 10% glucose IV if the blood glucose concentration does not rise 20 minutes after oral glucose.
why should SP02 monitoring be done on the R hand
because a patent ductus arteriosus may produce falsely low measurements in the left hand and feet. Place the probe over several digits if the probe is too large for a single digit.
difference in warming of preterm baby
The torso and limbs of a premature baby requiring resuscitation should be immediately wrapped in plastic without being dried and placed in a hot environment as soon as possible.
when should resuscitations attempts be stopped
Resuscitation attempts should usually be stopped if the baby is in asystole for more than ten minutes.
how to Draw up adrenaline for neonatal resuscitations
Use a 1 litre bag of 0.9% sodium chloride.
Add 1 ml of adrenaline from a 1 mg/ml ampoule.
Shake well and label.
Administer the volume from the tables as a IV bolus.
(0.001/1ml solution)
