Neonatal Resuscitation Flashcards
what is the normal neonatal heart rate?
120-160
what is the normal neonatal respiratory rate?
30-60
What is the normal neonatal SpO2 after birth transition is complete?
> 94%
What is the normal neonatal blood pressure in an infant that is to term?
50-65/35-40
What are the first things done to an infant post birth?
- Drying and warming
- Clearing airway
- Providing stimulation
- APGAR score
- Providing resuscitative care if needed
What is the range of the APGAR score?
0-10
When is the APGAR assessment performed?
1 minute of life and 5 minutes of life
What does a score of 7-10 on the APGAR score indicate?
normal, will receive routine observation and care
What does a score of 3-6 on the APGAR score indicate?
some assistance will be required, either via extra stimulation, oral suctioning and positive pressure ventilation
What does a score of 0-2 on the APGAR score indicate?
Severely depressed infant that requires resuscitation efforts
Why is it important to determine the APGAR score at 1 and 5 minutes?
To determine if the neonate is progressing or deteriorating
What is indicated if the APGAR score is less than 7 at 5 minutes?
- Major depression
- high risk of respiratory distress
- hypoglycemia
- transitional delay
What temperature should the radiant warmer be set to for infants?
36.5 and 37.5 celsius
Why is it important to warm infants?
- Reduces cold stress
- minimizes risk of respiratory depression due to hypothermia
Why is it important to reduce cold stress?
because it increases oxygen consumption
If a neonate needs resuscitation, what FiO2 should you start at?
> 35 weeks = 21%
<34 weeks =30%
Why is PEEP and CPAP used for neonatal resuscitations?
- Establish FRC
- Decrease resistance
- Increase compliance
- Reduce apnea
- Improves oxygenation
- Conserve surfactant
- Reduce lung injury and inflammation
- reduce need for ventilation
What are the indications for bag mask ventilation?
- Apnea
- Ineffective respiratory rate
- HR below 1oo beats per minute despite 100% FiO2
What rate should a neonate be bagged at?
40-60 bpm
What IP should be used when bagging a neonate?
20-25 cm H2O
What PEEP level should be used when bagging a neonate?
5 cm H2O
What are the indications for intubation for neonates?
- tracheal suctioning for meconium needed
- BMV is ineffective or prolonged
- Chest compressions are performed
- Tracheal administration of medications such as surfactant
What is the range of ETT sizes in neonates?
2-4, most common used are 3 and 3.5
How can you verify ETT location when you have intubated a neonate?
- Colorimetric CO2 monitor
- Chest radiograph
- Capnography
- Bilateral breath sounds
- Symmetrical chest wall movement
When should chest compressions be given during neonatal resuscitation?
if the heart rate is less than 60 after stimulation and 30 seconds of PPV
What are the options for vascular access in neonates?
- Umbilical vein
- Intraosseous
What are the benefits of umbilical vein vascular access?
- Easy access
- Easy cannulation
- Can be cannulated up to 1 week after birth
what is the pneumonic for post resuscitation neonatal care?
STABLE
What does the STABLE pneumonic stand for?
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
