Neonatal Resuscitation Medical Directive

Question 1

Neonatal Resuscitation Medical Directive

Note - def read the companion doc on this one

Answer 1

A Primary Care Paramedic may provide the treatment prescribed in this Medical Directive if authorized.

Question 2

Indications

Answer 2

Neonatal patient

Question 3

Conditions - Resuscitation

Answer 3

Age: <30 days of age
LOA: N/A
HR: N/A
RR: N/A
SBP: N/A
Other: N/A

Question 4

Contraindications - Resuscitation

Answer 4

N/A

Question 5

Treatment

Answer 5

Neonatal patient:
Term gestation and good muscle tone and breathing or crying?
Yes - Provide warmth; clear airway as necessary (do not routinely suction), dry; and ongoing evaluation. 
|----> Supportive care.
No - For 30 seconds: 
1. Provide warmth; 
2. Position/clear airway; and 
3. Dry, stimulate, reposition. 
*|------> Breathing and HR ≥100 bpm?
Yes - Supportive care.
No - For 30 seconds: 
1. Provide positive pressure ventilation (BVM) using room air. 
|-------> HR ≥60 bpm?
Yes - see *
!No - For 30 seconds:
1. Administer chest compressions; and
2. Provide positive perssure ventilation (BVM) using 100% oxygen
|------> HR ≥60 bpm?
Yes - see *
No -  see !
(Note from Liz: If older than 24 hours, do not delay chest compressions for bvm if in cardiac arrest, see companion doc.)

Question 6

Clinical Considerations

Answer 6

If neonatal resuscitation is required, initiate cardiac monitoring and pulse oximetry monitoring.

Question 7

Targeted Preductal SpO2 (Right Hand)

Answer 7

1 min 60% - 65%
2 min 65% - 70%
3 min 70% - 75%
4 min 75% - 80%
5 min 80% - 85%
10 min 85% - 95%