new born resiscitation

Question 1

Four reasons for neonatal resuscitation

Answer 1

Neonatal resuscitation
• Thick meconium
– Indicates fetal distress
• Not breathing or crying
– Gasping not same as crying
• Floppy tone
– Should be flexed at arms/legs and active
• Premature birth
– Stiffer lungs, weak muscles, get cold

Question 2

managment scale

1. always needed
2. needed less frequently
3. rarely

Answer 2

1. assess risk for needing resuscitation
   - provide warmth
   - position and clear airway
   - dry
   - stimulate to breathe
   - give O2 as necessary
2. assist ventilation with PPV
   - intubate trachea
   - chest compressions
3. medication

Question 3

1. routine care for newborn

2. not routine care

Answer 3

• provide warmth
• clear airway
• dry
• assess color

not routine

• provide warmth
• position; clear aiway
• dry, stimulate, reposition

Question 4

where does one listen to pulse on a newborn

Answer 4

-apical pulse
umbilicus
-brachial

Question 5

neonatal assessment:

• color
• signs of respiratory distress

Answer 5

1. central color, acrocyanosis
2. -increase WOB
   - nasal flaring
   - tachypnea
   - grunting

Question 6

indication of BVM (3)

Answer 6

• apnea
• HR <100
• persistent central cyanosis even with supplemental O2

Question 7

distinguish btw self infalting vs. flow dependent bag

Answer 7

self inflating

• inflates w/o gas source
• Peak Inspiratory Pressure (PIP) based on how hard squeezed
• cannot give Positive End Expiratory Pressure (PEEP) or Continuous Positive Airway Pressure (CPAP)

flow dependent bag

• inflates only with gas source
• PIP controlled by flow
• PEEP and CPAP controlled by flow-control valve

Question 8

signs of improvement after BMV

-trouble shooting if no improvment

Answer 8

• increase HR
• color
• tone
• adequae seal
• blocked airway
• not enough pressure

Question 9

indications for chest compressions

Answer 9

-after 15-30 sec of PPV with 100% O2 the heart rate is below 60, btw 60-80 not increasing

• 1 finger breadth below nipple line
• 1/3 A/P diameter
• thumb vs 2 finger
• ratio: 3 to 1

-after compressions, reassess
HR >60 STOP compression
HR <60 continue
continue BVM if HR less than 100

Question 10

characteristics of premature babies

Answer 10

-thin skin, large surface area small fat=heat loss
(<28 wks=ziploc)
-immature NS drive to breathe
-immature lungs, surfactant deficiency
(pneumothorax, need higher pressures)

Question 11

circumstances when no resuscitation needed

Answer 11

• confirmed <23 wks gestation
• less than 400g
• anencephaly
• confirmed trisomy 13 or trisomy 18