Newborn Resuscitation

Question 1

primary apnea

Answer 1

initial period of rapid breathing; reversible by mild stimulation and exposure to oxygen

Question 2

secondary apnea

Answer 2

HR, BP, and tone all diminish; UNRESPONSIVE to stimulation; REQUIRES assisted ventilation and oxygen or death will result

Question 3

one must assume the infant is in ____ apnea

Answer 3

secondary apnea (no way to differentiate)

Question 4

Routine Care for Resuscitation

Answer 4

1. Place under radiant heater
2. (suction trachea –if meconium stained fluid)
3. dry throughly
4. remove wet linen
5. position
6. suction MOUTH then NOSE
7. provide tactile stimulation

Question 5

if baby is not crying, what should you do?

Answer 5

ventilate with PPV 100% for 30 sec

Question 6

if the baby’s HR is >100, what do you do next?

Answer 6

evaluate color

Question 7

blue baby?

Answer 7

provide O2

Question 8

pink or baby with peripheral cyanosis?

Answer 8

observe and monitor

Question 9

what is the 1st step in resuscitation?

Answer 9

1. Place under radiant heater
2. (suction trachea –if meconium stained fluid)
3. dry throughly
4. remove wet linen
5. position
6. suction MOUTH then NOSE
7. provide tactile stimulation
8. observe

Question 10

What is the second step in resuscitation?

Answer 10

evaluate respiratory effort

Question 11

What is the 3rd step in resuscitation?

Answer 11

evaluate HR

Question 12

How can you take the pulse in a baby?

Answer 12

umbilical artery or apical pulse

Question 13

How long do you take a pulse?

Answer 13

6 seconds and multiply by 10

Question 14

HR >100

Answer 14

good; now go assess color

Question 15

HR <100

Answer 15

bad; provide PPV/O2

Question 16

acrocyanosis

Answer 16

hands and feet are blue, but the baby is perfusing well

Question 17

When is meconium a concern?

Answer 17

Full term and post term concern! Never a concern of prematurity

Question 18

Meconium definition

Answer 18

the 1st intestinal d/c of the newborn, composed of epi cells, fetal hair, mucus, and bile

Question 19

T or F Meconium could be a sign of distress.

Answer 19

T

Question 20

When do 99% of infants pass their 1st stool?

Answer 20

Within the first 24-48h

-may be passed in utero by term and post-term infants in 8-20% of births

Question 21

What is the most important thing to do if meconium is present at delivery?

Answer 21

Prevention of meconium aspiration–DO NOT STIMULATE

Question 22

Suction should be less than ____mmHg because _____

Answer 22

<100mmHg to prevent damage to the nasal turbinates

Question 23

Most infants that need intervention will respond to____ and ____

Answer 23

stimulation and oxygenation

Question 24

When do you start chest compressions on an infant?

Answer 24

HR t respond to ventilation

Question 25

When is the APGAR score assessed?

Answer 25

at 1 and 5 minutes (occasionally at 10min for depressed infants)

Question 26

What prevents most children from getting a perfect score?

Answer 26

acrocyanosis

Question 27

What 3 things does the APGAR not tell you/not help you with?

Answer 27

1. does not define asphyxia
2. does not predict future outcomes
3. not used to determine resuscitaiton efforts

Question 28

What 5 things does the APGAR assess

Answer 28

A-appearance/color
P-pulse
G-grimace/reflex irritability (2=crying vigorously)
A-activity/m.tone (2=active movement)
R- respirations (slow/irreg vs good/crying)