Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Paediatrics > Neonatal Resuscitation > Flashcards

Neonatal Resuscitation Flashcards

1
Q

In the Helping Babies Breath (HBB) Algorithm, what are the 5 steps to be completed in the 1st minute of life (if required)?

A
  1. Warm and dry the baby
  2. Airway positioning +- suction
  3. Active stimulation
  4. Clamp and cut the cord
  5. Start ventilation with bag-valve mask
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Ideally, if you arrive pre-delivery, what should you do to prepare? (3 items)

A
  1. Check your equipment and tools
  2. Brief the team
  3. Communicate with the mother (if appropriate)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe your process of checking a resuscitaire ( 11 items)

A
  1. Switch on machine + heat/light source
  2. Check towels or cloths available
  3. Check mask -size appropriate for the patient
  4. Set inflation pressures - appropriate for GA
  5. Check functioning bag-valve-mask
  6. Check oxygen source
  7. Check suction
  8. Stethoscope
  9. Cord clamp
  10. Scissors or scalpel
  11. Hat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Baby arrives - what do you do? (3 items)

A
  1. Start the clock
  2. Dry and stimulate with warm towels/cloths
  3. Assess colour, tone, breathing and heart rate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

For low resource settings - what do you do next if the baby is floppy and not breathing (3 items)

A
  1. Position the airway (neutral)
  2. Site the face mask
  3. Deliver ventilation breaths
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How long do you deliver these ventilation breaths, before you reassess?

A

30 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How will you know if your ventilation has been effective?

A
  1. Rise and fall of the chest - chest expansion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What will you do if you did not see the chest rise? (3 items)

A
  1. Reposition the airway
  2. Reposition the mask
  3. Check BVM connection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What will you do if after 30 seconds you still did not see the chest rise? (3 items)

A
  1. Trial 2 person technique
  2. Consider airway adjunct
  3. Consider an increase in inflation pressures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the ratio of chest compressions to ventilation breaths for neonatal resuscitation?

A

3: 1

3 compressions to 1 breath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the dose of adrenaline mg/kg in neonatal resuscitation?

A

0.01mg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the strength of adrenaline used in neonatal resuscitation?

A

1:10,000 = 1mg/1ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do you create a dilute solution of adrenaline for neonatal resuscitation?

A

1ml of (1mg/ml) Adrenaline mixed with 9ml 0.9% sodium chloride = 10ml solution at 0.1mg/ml strength

Remember the neonatal dosing is 0.01mg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

With a 0.1mg/ml solution of Adrenaline and a 3kg infant - how much Adrenaline should you use (in ml) for neonatal resuscitation?

A

0.01 x 3 = 0.03mg dose

1ml =0.1mg

0.1ml = 0.01mg

therefore

0.3ml = 0.03mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

In a low resource setting (MSF guideline) when should you consider stopping neonatal resuscitation? (2 items)

A
  1. No HR after 10 mins

2. No spontaneous breathing after 20 mins (even IF heart rate is present)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What 3 things should you MEASURE in a post-resuscitation scenario?

A
  1. Temperature
  2. Glucose
  3. Oxygen saturations (if able)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What should you EXAMINE for post-resuscitation?

A

Neonatal danger signs - systems review style ABC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What should you RECORD following a resuscitation? (4 items)

A
  1. What you needed to do
  2. Retrospective APGAR score
  3. Follow up plan - admit and/or observe
  4. Communication with family
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Who should you COMMUNICATE with post-resuscitation? (3 items)

A
  1. Mother (+ family)
  2. NICU team (if needed)
  3. Obstetric team/midwives
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the 5 components of the APGAR score?

A
  1. Colour
  2. Irritability
  3. Tone
  4. Breathing
  5. Heart rate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the maximum number of points for each component on the APGAR score?

A

2 points

Each component score 0-2

A maximum score of 10

22
Q

At what intervals is the APGAR score ideally performed?

A

1 and 5 minutes after birth

23
Q

At 1 minute of life an infant has an APGAR score of 0-4, what does that suggest?

A

Birth Asphyxia (HIE risk)

24
Q

At 1 minute of life an infant has an APGAR score of 5-7, what does that suggest?

A

Difficult adaptation

25
Q

At 1 minute of life an infant has an APGAR score of 8-10, what does that suggest?

A

Good adaptation

26
Q

At 5 minutes of life what APGAR score would suggest a birth asphyxia risk?

A

A score of 0-6

27
Q

At 5 minutes of life what APGAR score would suggest a difficult adaptation?

A

A score of 7-8

28
Q

At 5 minutes of life what APGAR score would suggest a good adaptation?

A

A score of 8-10

29
Q

What is the threshold of significant concern for an APGAR score at 1 and 5 minutes, respectively? (2 items)

A

A score of less than or equal to 4 at 1 min

A score of less than or equal to 6 at 5 mins

30
Q

What does the APGAR score NOT tell you?

A

It does not have prognostic value for an individual infant beyond the time of birth

31
Q

Referring to ANTEPARTUM MATERNAL risk factors for neonatal resuscitation - What age extremes will increase risk?

A

Mother < 15 years

Mother > 35 years (considered old in childbearing terms)

32
Q

Referring to ANTEPARTUM MATERNAL risk factors for neonatal resuscitation - what 5 maternal features would raise your concern?

A
  1. Multiple pregnancies (twins/triplets)
  2. Maternal infection
  3. Bleeding in second/third trimester
  4. Maternal medications
  5. Previous loss of an infant in the prenatal, intrapartum or neonatal periods
33
Q

Referring to INTRAPARTUM maternal risk factors for neonatal resuscitation - What types of delivery are increased risk (3 items)

A
  1. Emergency cesarean section (LSCS)
  2. Under general anaesthesia
  3. Instrumental delivery
34
Q

What does a prolonged second stage mean?

A

The second stage of labour lasting > 2 hours

Note: The second stage = fully dilated cervix + baby to descend in vagina.

Prolonged second stage = risk factor for neonatal resuscitation

35
Q

Labour lasting greater than … hours (overall) is a higher risk for neonatal resuscitation.

A

24 hours

36
Q

How is prolonged rupture of membranes defined?

A

A pre-labour rupture of membranes of > 18 hours (without commencement of delivery)

Note: Distinct from Pre-term premature rupture of membranes

PROM is a risk factor for neonatal resuscitation

37
Q

List 3 INTRAPARTUM Infant factors that increase the risk of neonatal resuscitation.

A
  1. Macrosomia (large baby)
  2. Fetal bradycardia
  3. Meconium stained liquor (significant not light)
38
Q

What does SIGNIFICANT meconium-stained liquor signify?

A

The fetus passes meconium into the amniotic fluid during the antepartum or intrapartum period.

Significant = Dark green or black fluid that is thick +_ particulate matter

Aetiology unclear - thought to signify a response to some form of stressor

Increased risk for fetal outcomes (short and long term) + of neonatal resuscitation

39
Q

What is INSIGNIFICANT meconium-stained liquor?

A

Liquor that is stained yellow or pale green, without particulate matter - considered lower risk

40
Q

List 4 INTRAPARTUM Maternal factors that increase the risk of neonatal resuscitation.

A
  1. Placenta Praevia
  2. Umbilical cord prolapse
  3. Maternal interuterine infection (chorioamnionitis)
  4. Heavy bleeding (other cause)
41
Q

What are acceptable neonatal oxygen saturations at 2 minutes of life?

A

60%

42
Q

What are acceptable neonatal oxygen saturations at 3 minutes of life?

A

70%

43
Q

What are acceptable neonatal oxygen saturations at 4 minutes of life?

A

80%

44
Q

What are acceptable neonatal oxygen saturations at 5 minutes of life?

A

85%

45
Q

What are acceptable neonatal oxygen saturations at 10 minutes of life?

A

90%

46
Q

What % of infants require help to breathe at birth?

A

10%

100/1000

47
Q

What % of infants require cardiac massage at birth?

A

<1%

<10/1000

48
Q

What is the goal for temperature regulation of a neonate during resuscitation?

A

Maintain a temperature of 36.5-37.5 degrees

49
Q

What could you do to maintain the temperature of a premature infant of 32 weeks GA or less (4 items)?

A
  1. Thermal mattress
  2. Plastic bag up to the neck
  3. Hat
  4. Warmed resuscitation gases (if possible)
50
Q

What should the temperature of the delivery room be for an infant 32 weeks and under?

A

23-25 degrees C

51
Q

Give 2 reasons why deep suctioning of the airway is NOT advised.

A
  1. Vagal nerve stimulation –> Bradycardia

2. Possible trauma of oropharynx

Paediatrics (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions