Neonatal Resuscitation Flashcards
1
Q
When is resuscitation most likely to be needed?
A
- it is more likely to be needed by babies with intrapartum evidence of significant fetal compromise, babies delivering before 35 weeks gestation, babies delivering vaginally by breech presentation, maternal infection and multiple pregnancies
- Caesarean section is also associated with an increased risk of problems with respiratory transition at birth requiring medical interventions
2
Q
What happens to the hypoxic infant when it’s lungs are aerated?
A
- if the lungs are aerated effectively and the infants circulation is functioning sufficiently well, oxygenated blood will then be conveyed from the aerated lungs to the heart
- the heart rate will increase and the brain will be perfused with oxygenated blood
- following this the neural centres responsible for normal breathing will usually function again and the infant will recover
3
Q
Why should the infant be kept warm and what are the initial steps of the resuscitation?
A
- dry the infant, change to dry towels and place hat
- cut and clamp cord after 1 minute as it allows time for placental transfusion
- temperature should be maintained between 36.5 degrees and 37.5 degrees
- this will provide significant stimulation and will allow time to asses the infants breathing, HR, colour and tone
- in the first few minutes the HR is usually judged best by listening through a stethoscope, however an ECG or pulse oximetry may be considered further down the line
4
Q
How should the airway be maintained?
A
- before the infant can breathe effectively the airway must be open
- the infant should be placed on his back with the head in the neutral position
- most newborns have a prominent occiput so will tend to flex the neck so this can be avoided with some support under the shoulders
- a jaw thrust or airway may also need to be used
- check mouth see if there is anything obvious in mouth, should only suction if something is clearly visible
