Newborn

Question 1

1. What wrist should pulse oximeters be placed on newborns?

Answer 1

Right - pre-ductal

Question 2

2. What should be done for very premature infants (<32wks) or <1500g?

Answer 2

Place into zip lock bag with head sticking out, and put beanie on head

Question 3

3. What are the considerations for cutting the cord?

Answer 3

• Vigorous: not urgent, wait until stops pulsating (1-2mins)

- Non-vigorous: prioritise resus, may need to cut cord earlier to facilitate

Question 4

4. What needs to be done for a vigorous newborn?

Answer 4

• Dry the baby, especially the head
• Maintain warmth (skin-to-skin, blankets, hat)
• Routine suction not recommended
• Monitor HR (auscultate), breathing, tone and colour

Question 5

5. Flowchart for newborn resus:

Answer 5

• Apnoeic/gasping or no muscle tone: stimulate by drying (<30secs), maintain warmth, place supine, suction only if airway obstructed
• HR<100 or apnoeic/gasping:
  IPPV 40-60p/min room air + pulse ox + ECG, reassess after 30secs
• HR <60: CPR @3:1 ratio with 5L/min O2
• HR 60-100: IPPV 40-60, if no increase in HR add 5L/min O2
• HR >100 but SpO2<90%: laboured breathing IPPV 40-60 with O2 1-5L/min; normal breathing titrate O2 1-2L/min, discontinue when Sats >90%

Question 6

6. What are the considerations for suctioning newborns?

Answer 6

Mouth first then nose - newborn is nasal breather and may gasp and inhale pharyngeal fluid if nose cleared first
5-6 secs, no deeper than oropharynx and only suction as catheter is being withdrawn

Question 7

7. CPR criteria for newborn:

Answer 7

• 3:1 ratio
• 90 compressions and 30 ventilations p/min, 0.5sec pause for ventilation
• Single rescuer - focus is on effective IPPV