NeoNatal Resusitation Flashcards
Name the three things we must consider about babies at birth in relation to NeoNatal resuscitation.
- Babies are small and therefore general resuscitation cannot be used.
- Babies are born with their lungs full of fluid.
- Babies are wet at birth and therefore we must dry and warm them immediately to regulate their temperature.
Name 4 factors that will stimulate babies first breath.
- Stress of labour.
- Cold air outside of the womb.
- Knotted or obstructed umbilical cord.
- Physical discomfort during labour.
Why is the first breath so important?
It pushes the fluid from the babies airway and lungs which allows for the babies breathing to regulate and for a resting lung volume to establish.
What is gasping?
A response from the brain when their is a lack of oxygen. If the umbilical cord has been obstructed, the babies may begin to gasp because they are not receiving oxygen via the mothers placenta. Gasping is very similar to agonal breathing in adults. It is a brain stem reflex rather than a reaction of the lungs.
What is primary apnea?
The babies oxygen supply is limited and may become apnic (I.e. baby will stop breathing altogether). The heart rate of the baby will drop but the blood pressure will increase as a primary response to the lack of oxygen.
What is secondary apnea?
When asphyxia continues after Primary apnea, the baby will begin to gasp- the brains response to try and take on oxygen. The heart rate and blood pressure will drop and the infant does not respond to any stimulation. The baby will die if resuscitation does not begin immediately.
When assessing a newborn, what are the four things we are looking at?
- Babies colour (pink, blue or white)
- Babies tone (how well muscles are able to told themselves)
- Babies breathing (is baby struggling? Is breathing fast or slow?)
- Heart rate (is the heart rate strong and fast or laboured?)
A newborn baby is pink, with blue extremities. It’s muscular tone and good, breathing is regular and heart rate is strong. What do we do?
Dry the baby and make sure it is warm. Pass to mum for skin to skin contact.
A newborn baby is blue with moderate muscular tone, slightly laboured breathing and a slow but present heart rate. What do we do?
Dry the baby and open the airway by holding its head in a neutral position. Begin inflation breaths and reassess situation after 5 breaths (each lasting 2-3 seconds).
A newborn baby is very pale, with a blue tinge. It’s muscular tone is poor and the babies limbs are floppy. The baby does not appear to be breathing and the heart rate is present but very slow. What do we do?
Dry the baby, open the airway by placing the babies head in a neutral position. Perform 5 inflation breaths (each lasting 2-3 seconds each). Watch for chest rising and then recheck the heart rate. If the heart rate does not respond, we must perform compressions.
If the heart rate rises but the baby is still not breathing, we must continue ventilation but compressions are not necessary.
When performing compressions on a newborn baby, how many rescue breaths do we do in ratio to the heart compressions?
After the first five initial rescue breaths if their is no response from the heart, we must perform rescue breaths and compressions in a 3:1 ratio. Each rescue breath must last 2-3 seconds, and heart compressions must be done with the second and third finger.
Following neonatal resuscitation, after stabilising the babies breathing and heart rate, what must we do?
Continue to monitor the babies vital signs and allow for mother and baby to have skin to skin contact.
What is a healthy heart rate for a neonate?
110-160 bpm
Before assessing the baby during NeoNatal resuscitation, what 4 things must we do?
- start the clock
- call for help
- dry the baby so they are not cold
- stimulate the baby to encourage breathing
