Neonatal resus

Question 1

Which babies are unlikely to require resuscitation?

Answer 1

• > 37 weeks gestational age
• Amniotic fluid clear of meconium and evidence of infection
• Baby is breathing and crying normally
• Baby has good muscle tone

Question 2

What is the first thing you do to manage a very low birth weight baby (<1500g), straight after birth?

Answer 2

Cover in plastic wrap/bag immediately to prevent heat loss (everything else can be done with the baby covered in plastic)
Ensure the baby’s airway and head aren’t covered

Question 3

What are the major drawbacks of deep, vigorous suctioning of a neonate?

Answer 3

• Bradycardia due to vagus nerve stimulation

- Laryngospasm

Question 4

When does a baby need resuscitation?

Answer 4

If any one of the following three are present:

• Not breathing adequately
• Heart rate < 100 bpm
• Poor muscle tone

Question 5

How frequently should you re-assess the heart rate and respiration of a baby that you are resuscitating?

Answer 5

Every 30 seconds

Question 6

What are the components of the Apgar score?

Answer 6

A - Appearance/complexion
P - Pulse
G - Grimace
A - Activity
R - Respiration

Question 7

What is considered a “normal” Apgar score?

Answer 7

> 7

Question 8

Who is naloxone given to?

Answer 8

Baby whose mother received narcotic analgesic within 4 hour of delivery

Question 9

Dose of naloxone

Answer 9

0.1mg/kg (0.25ml/kg) IM or IV

May need to be repeated after 2 hours to avoid apnoeic spells

Question 10

When to stop chest compressions

Answer 10

HR over 60/min

Question 11

Depth of compression

Answer 11

1/3 depth

Question 12

Reasons for poor chest rise during ventilation

Answer 12

Mask seal
Obstruction
Ventilate more firmly
Intubation needed?
Nasal choanal atresia
Gastric distension

Question 13

ET tube sizes per weight

Answer 13

3000 - 3.5-4.0

Question 14

Insertion depth for ET tube

Answer 14

Weight in kg + 6cm

Question 15

How long to attempt intubation

Answer 15

20s

Question 16

Baby fail to improve after ET tube inserted. Cause?

Answer 16

Displaced/ dislodged tube
Obstruction
Pneumothorax 
Equipment failure
Stomach distension

Question 17

Dose of bicarbonate if given

Answer 17

2mls of 4.5%/kg IV over 2 mins

Question 18

If saline needed to increase blood volume, what dose?

Answer 18

10ml/kg via umbilical venous line over several mins

Question 19

Glucose dosage to in neonate

Answer 19

2-4ml 10% dextrose per kg

If below 1.5 give 10% des at 60ml/kg/day

Question 20

Normal 02 seats after birth

Answer 20

1 min >60%
2 mins >65%
3 mins >70%
4 mins >75%
5 mins >80%
10 and above 85-95%