Newborn Managment OME

Question 1

What is the APGAR Score? How do you score it? (1 pt vs 2pts)

Answer 1

• Appearance = 1:Acrocyanosis, 2: pink
• Pulse = 1: <100, 2:>100
• Grimace = 1:with HIGH stim, 2: w/stim
• Activity = 1: Flexion, 2: extension
• Respiration = 1: irregular, 2: strong/regular

0 = shits absent
normal = 7-10

Question 2

Between birth - 1 min what do you do? normal?

Answer 2

1. Stimulate baby via rubbing back wiht towel + tap feets(1 apnea)
2. O2(2nd apnea)
   - -O2 = 60-65% - suction nose and mouth *PPV or intubate?
3. HR
   - - >100 = good!
   - - <100 = PPV - baby may not be getting enough air immediately

Question 3

Between 1 - 5 min what do you do? normal?

Answer 3

1. APGAR
2. O2(2nd apnea)
   - -O2 = 80-85%
   * FiO2 to improve! = supp O2
   * PPV or intubate?
3. HR
   - - >100 = good!
   - - 60-100 = PPV
   - -<60 = CPR 3:1 + Epi ==> run code

Question 4

Between 5 - 10 min what do you do? normal?

Answer 4

1. APGAR
2. O2(2nd apnea)
   - -O2 = 90-95% is good
   * FiO2 to improve! = supp O2
   * PPV or intubate?
3. HR
   - - >100 = good!
   - - 60-100 = PPV
   - -<60 = CPR 3:1 + Epi ==> run code

Question 5

Transient Tachypnea of the Newborn(TTN)

Answer 5

abnormal rapid breathing w/grunting + hyperexpanded and wet appearing CXR. due to delayed clearance of fetal lung fluid, usually seen with C-sections. Usually resolves w/in 6hrs but may be present for up to 48h.

tx: Supplemental O2, CPAP/intubate is needed

Question 6

Respiratory Distress Syndrome of Newborn(RDS)

Answer 6

usually due to surfactant deficiency causing atelectasis. baby is usually premature. CXR: low lung volumes and uniform granular pattern.

tx: surfactant + mechanical ventilation

Question 7

What do you have to check immediately after birth (assuming baby is 7+ APGAR)?

Answer 7

1. umbilical cord(2a +1v)
2. Weight
3. Length
4. head circumference
5. glucose
6. shots and drops(Vit K, Hep B, PPx of conjunctivitis w/erythromycin unless another organism already ID.)

Question 8

What are Shots & Drops?

Answer 8

Vit K, Hep B, PPx of conjunctivitis w/erythromycin unless another organism already ID

–> given to baby w/ APGAR 7+