Newborn Resuscitation Flashcards
Newborn Resus
What are the indications?
Newborn pt
Newborn Resus
What are the CONDITIONS for PPV - Positive Pressure Ventilation?
Pt is LESS than 24h old
AND
pt has LESS then 100bpm
Newborn Resus
What are the CONTRAINDICATIONS for PPV - Positive Pressure Ventilation?
Pt is obviously dead as per the BLS PCS
Presumed gestational age is LESS than 20 weeks
Newborn Resus
What are the CONDITIONS for CPR?
pt is LESS than 24h old
AND
pt has LESS then 60bpm
AND (it’s)
Only after 30sec of PPV using room air
Newborn Resus
What are the CONTRAINDICATIONS for CPR?
Pt is obvioulsy dead as per the BLS PCS
Presumed gestational age is LESS than 20 weeks
Clinical Considerations
What equipment should you be using during a neonatal resuscitation?
Cardiac monitoring
AND
Pulse oximetry (preductal SpO2)
Clinical Considerations
At what gestational age would you initiate transport as infants born between then are stillborn or die quickly?
20-25 weeks
Clinical Considerations
What do you do if gestational age cannot be determined?
Initiate resuscitation
AND
rapid transport
Clinical Considerations
When is resuscitation futile?
What should you be doing?
at LESS than 20 weeks gestation
Providing the newborn with warmth as you patch BHP
Newborn Resus
MR SOPA go!
M - Mask readjustment
R - repositioning/reposition head
S - suction mouth and nose
O - open mouth, lift the jaw
P - increase pressure to achieve chest rise
A - airway adjunct (lil opa/npa)
Newborn Resus
What (if ABSENT or ABNORMAL) would trigger you to start resuscitative assessment and interventions?
As this standard is for anyone LESS than 24h, what should you do if they’re not immediatly born?
Term gestation
Good muscle tone
Breathing or crying
Assess respirations, HR, then proceed with the standard
Newborn Resus
What’s the treatment plan for meconium, poor muscle tone, and poor breathing/crying?
What’s meconium? Is routine suction required?
Does epi apply (in terms of anaphylaxis)?
suction the mouth and pharynx before the nose while ensuring O2 is maintained
The babies first poo. NO
NO
Newborn Resus
When is O2 administration NOT required?
What should you do if the newborn is in respiratory distress?
When the newborn has central cyanosis BUT RR appears adequate
AND
a HR greater than 100bpm
Adminiter O2 at 6-8 lpm either by mask or 1-2cm from the pt’s face - withdraw as the pt’s colour improves
Newborn Resus
Show me the TREATMENT PLAN flowchart?
What are the signs of respiratory distress?
Nasal flaring
Grunting
Sternal Retractions
Newborn Resus
In what location do you put the preductal SpO2?
WHY?
What’s the targeted range?
The right hand - becuse coming off of the right side of the heart is the aorta that then seperates into different arteries specifically the subclavian than further seperates to immeditalely prefuse the brain and right arm - the blood at the right hand would be most accurate
Neonate Standard
What’s APGAR stand for and break it down for me?
A - Appearance
P - Pulse
G - Grimace
A - Activity
R - Respiration
Newborn Treatment Plan
What 3 things does the newborn have to have?
What’s the next step if they have all 3?
What’s the final step?
Term gestation
Good muscle tone
Breathing or crying
Provide warmth - clear the airway as necessary
Provide supportive care
Newborn Treatment Plan
What if they don’t have all 3?
What if that doesn’t work?
What are you looking for?
Then provide (for 30sec):
- warmth + Stimulation, repositioning, and drying
- airway clearing/positioning
Check HR and RR - put on monitors if time permits
HR to be GREATER/EQUAL to 100bpm - if it is then provide supportive care
Newborn Treatment Plan
What do you do if the HR are below 100bpm?
What are you looking for next?
What if the HR is below 60bpm?
Provide PPV using a BVM on room air for 30sec
The HR to be GREATER/EQUAL to 60bpm - if it is then repeat the BVM treat
Provide chest compressions
AND
PPV using a BVM with 100% oxygen
for 30sec
Newborn Treatment Plan
What if after performing CPR and BVM with 100% oxygen the HR is below 60bpm?
What are you doing if the HR make GREATER/EQUAL to 60bpm?
Then repeat the chest compressions and BVM with 100% oxygen for another 30sec - keep doing this until the HR goes GREATER/EQUAL to 60bpm
Start over by checking if the HR is GREATER/EQUAL to 100bpm.
