NICU Basics

Question 1

In NRP, what are the initial indications for starting PPV?

Answer 1

apnea, gasping, or HR <100

Question 2

At 1 minute of life, normal SpO2 is

Answer 2

60 to 65%

Question 3

At 5 min of life, normal SpO2 is

Answer 3

80 to 85%

Question 4

At 10 min of life, normal SpO2 is

Answer 4

85 to 95%

Question 5

If during a delivery/resuscitation a baby has persistent cyanosis or is not meeting O2 targets, what should you do?

Answer 5

blowby O2 or CPAP

Question 6

When should you start PPV during a resuscitation?

Answer 6

For HR <100, no respiratory effort, apnea or gasping

Question 7

During a resuscitation, when should you start compressions?

Answer 7

When HR is <60 and did not improve with PPV or intubation–> then you start cmpressions

Question 8

What should your initial settings be when prepping for a resuscitation?

Answer 8

O2: 21% (21 to 30% if infant is <35 weeks)

Flow: 10 L/min

PIP: 20-25 cm H20 (max 40)

PEEP: 5 cm H20

Suction: 80 to 100 mm Hg, 6 or 8 French catheter

Question 9

When do you use MR SOPA, and what does MR SOPA stand for?

Answer 9

Use when PPV does not seem to be working–as in you don’t see chest rise, and HR is not going up.

Mask readjustment 
Reposition airway
Suction
Open mouth
increase Pressure (up to PIP of 40)
Alternative airway--> LMA or ET tube

Question 10

In general, ET BLADE size you should use for a term infant during a resuscitation

Answer 10

1

Question 11

Blade size for intubating a preemie

Answer 11

0

00 for micro premie

and 1 for term infant

Question 12

ET tube size for a term baby

Answer 12

3.5

Question 13

A baby over 2 kg should get this size ET tube

Answer 13

3.5

use this for babies > 2 kg and/or >34 wks

Question 14

A baby weighs between 1 kg and 2 kg. Use this size ET tube

Answer 14

3

in general use for gestational age 28 to 34 wks

Question 15

For an infant weighing <1000 g, use this size ET tube

Answer 15

2.5 (in general is for babies less than 28 wks)

Question 16

When can you stop compressions?

Answer 16

When HR is above 60

but continue PPV

Question 17

If you give a NS bolus, how much should the bolus be

Answer 17

10 mg/kg

given over 5 to 10 min

Question 18

If you give a D10W bolus, how much should it be

Answer 18

2 mL/kg over 2 to 3 min

Question 19

Early CPAP is for babies under this gestational age

Answer 19

32 weeks

Question 20

Epi dose

Answer 20

IV: 0.1 mg/kg of 1:10,000
ET: 1 mg/kg
THIS MAY BE WRONG—CLARIFY!!!

Question 21

How deep should you place ET tube for a baby weighing under 1 km, less than 28 weeks?

Answer 21

6 to 7 cm

Question 22

How deep should you place ET tube for a baby weighing between 1 and 2 kg, between 28 and 34 weeks?

Answer 22

7 to 8 cm

Question 23

How deep should you place ET tube for a baby weighing between 2 and 3 kg, between 34 and 38 weeks?

Answer 23

8 to 9 cm

Question 24

How deep should you place ET tube for a baby weighing over 3 kg, and over 38 weeks?

Answer 24

9 to 10 cm

Question 25

Depth of a UAC should be

Answer 25

3 x weight + 9

This should be at T6 to T9

Question 26

Depth of a UVC should be

Answer 26

1/2 (UAC) + 1

should be right above the diaphragm

Question 27

ELBW

Answer 27

less than 1 kg

Question 28

VLBW

Answer 28

less than 1500 g

Question 29

LBW

Answer 29

less than 2500 g

Question 30

What is a normal birth weight?

Answer 30

2500 to 4000 g

Question 31

Normal RR in the NICU

Answer 31

30 to 60

Question 32

Define apnea

Answer 32

No breathing for over 20 seconds, OR, over 20 seconds but with bradycardia or desats

Question 33

Mean arterial pressure should be roughly greater than or equal to

Answer 33

PMA

Question 34

If PMA is 27 weeks, MAP should not be below

Answer 34

27

Question 35

What is a normal Hb at birth?

Answer 35

13.5 to 22

In Hct, this is 42 to 60

Question 36

At 15 days to 1 mo, what is a normal Hb?

Answer 36

10 to 20

In Hct, this is 31-55

Question 37

What is a normal WBC at birth?

Answer 37

9 to 34

Question 38

At 8 days of life, what is a normal WBC?

Answer 38

5 to 21

Question 39

What is a normal Hb nadir and when does it usually happen?

Answer 39

Nadir is Hb of 11

For a term baby, happens at age 8 to 12 weeks.

For a preterm baby, happens at 4-8 weeks, and the nadir will actually be lower, with a Hb of 7 to 9 .