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Pediatrics > Neonatal Resuscitation > Flashcards

Neonatal Resuscitation Flashcards

1
Q

what is the normal neonatal heart rate?

A

120-160

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2
Q

what is the normal neonatal respiratory rate?

A

30-60

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3
Q

What is the normal neonatal SpO2 after birth transition is complete?

A

> 94%

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4
Q

What is the normal neonatal blood pressure in an infant that is to term?

A

50-65/35-40

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5
Q

What are the first things done to an infant post birth?

A
  1. Drying and warming
  2. Clearing airway
  3. Providing stimulation
  4. APGAR score
  5. Providing resuscitative care if needed
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6
Q

What is the range of the APGAR score?

A

0-10

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7
Q

When is the APGAR assessment performed?

A

1 minute of life and 5 minutes of life

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8
Q

What does a score of 7-10 on the APGAR score indicate?

A

normal, will receive routine observation and care

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9
Q

What does a score of 3-6 on the APGAR score indicate?

A

some assistance will be required, either via extra stimulation, oral suctioning and positive pressure ventilation

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10
Q

What does a score of 0-2 on the APGAR score indicate?

A

Severely depressed infant that requires resuscitation efforts

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11
Q

Why is it important to determine the APGAR score at 1 and 5 minutes?

A

To determine if the neonate is progressing or deteriorating

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12
Q

What is indicated if the APGAR score is less than 7 at 5 minutes?

A
  1. Major depression
  2. high risk of respiratory distress
  3. hypoglycemia
  4. transitional delay
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13
Q

What temperature should the radiant warmer be set to for infants?

A

36.5 and 37.5 celsius

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14
Q

Why is it important to warm infants?

A
  1. Reduces cold stress
  2. minimizes risk of respiratory depression due to hypothermia
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15
Q

Why is it important to reduce cold stress?

A

because it increases oxygen consumption

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16
Q

If a neonate needs resuscitation, what FiO2 should you start at?

A

> 35 weeks = 21%
<34 weeks =30%

17
Q

Why is PEEP and CPAP used for neonatal resuscitations?

A
  1. Establish FRC
  2. Decrease resistance
  3. Increase compliance
  4. Reduce apnea
  5. Improves oxygenation
  6. Conserve surfactant
  7. Reduce lung injury and inflammation
  8. reduce need for ventilation
18
Q

What are the indications for bag mask ventilation?

A
  1. Apnea
  2. Ineffective respiratory rate
  3. HR below 1oo beats per minute despite 100% FiO2
19
Q

What rate should a neonate be bagged at?

A

40-60 bpm

20
Q

What IP should be used when bagging a neonate?

A

20-25 cm H2O

21
Q

What PEEP level should be used when bagging a neonate?

A

5 cm H2O

22
Q

What are the indications for intubation for neonates?

A
  1. tracheal suctioning for meconium needed
  2. BMV is ineffective or prolonged
  3. Chest compressions are performed
  4. Tracheal administration of medications such as surfactant
23
Q

What is the range of ETT sizes in neonates?

A

2-4, most common used are 3 and 3.5

24
Q

How can you verify ETT location when you have intubated a neonate?

A
  1. Colorimetric CO2 monitor
  2. Chest radiograph
  3. Capnography
  4. Bilateral breath sounds
  5. Symmetrical chest wall movement
25
Q

When should chest compressions be given during neonatal resuscitation?

A

if the heart rate is less than 60 after stimulation and 30 seconds of PPV

26
Q

What are the options for vascular access in neonates?

A
  1. Umbilical vein
  2. Intraosseous
27
Q

What are the benefits of umbilical vein vascular access?

A
  1. Easy access
  2. Easy cannulation
  3. Can be cannulated up to 1 week after birth
28
Q

what is the pneumonic for post resuscitation neonatal care?

A

STABLE

29
Q

What does the STABLE pneumonic stand for?

A

1.Sugar monitoring and treatment
2Temperature stabilization and maintenance
3. Airway, normal and patent
4. Blood pressure
5. Lab work = acid base and electrolyte balance
6. Emotional support

Pediatrics (10 decks)

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