Neonatal Resuscitation

Question 1

Give the procedure for neonatal resuscitation

Answer 1

1. Dry baby, assess
2. If not breathing, give 5 inflation breaths
3. If no increase in HR, check for chest movement
4. If chest not moving, recheck head position, consider 2-person control, repeat 5 inflation breaths until chest movement is seen (consider intubation, suction etc)
5. If chest is moving but HR <60, ventilate for 30 secs
6. Reassess - if still <60, start chest compressions 3:1
7. Reassess heart rate every 30 secs
8. If no improvement, consider additional measures

Question 2

What are the additional measures to consider if the heart rate does not pick up?

Answer 2

• Venous access

- Drugs

Question 3

What position should the baby’s head be in?

Answer 3

Neutral

Question 4

What is PEEP?

Answer 4

Positive End-Expiratory Pressure (helps to keep the lungs inflated)

Question 5

What is CPAP?

Answer 5

Continuous Positive Airway Pressure
- used for respiratory support spontaneously breathing preterm infants who are suffering from respiratory distress to reduce the risk of RDS

Question 6

What pressures should be used for resuscitation?

Answer 6

Inflation breaths:
Term infants = 30cm H2O
Preterm infants = 20-25cm H2O
PEEP: 4-5cm H2O
CPAP: 5cm H2O

Question 7

What drugs may be used to encourage cardiac activity?

Answer 7

• Adrenaline
• Sodium bicarbonate
• Glucose
• Dextrose

Question 8

When should resuscitation be stopped?

Answer 8

No detectable cardiac activity for 10 minutes

Question 9

What may be used post-resuscitation to prevent adverse effects?

Answer 9

Therapeutic Hypothermia

• treats moderate to severe HIE
• either whole body or selective head cooling
• commence within 6 hrs, continue for 72 hrs, re-warm infant over 4 hours

Question 10

What is HIE?

Answer 10

Hypoxic-Ischaemic Encephalopathy

brain injury caused by asphyxia

Question 11

What is asphyxia?

Answer 11

Suffocation

Question 12

What must also be monitored very closely following resuscitation?

Answer 12

Blood sugars