NICU Basics Flashcards
In NRP, what are the initial indications for starting PPV?
apnea, gasping, or HR <100
At 1 minute of life, normal SpO2 is
60 to 65%
At 5 min of life, normal SpO2 is
80 to 85%
At 10 min of life, normal SpO2 is
85 to 95%
If during a delivery/resuscitation a baby has persistent cyanosis or is not meeting O2 targets, what should you do?
blowby O2 or CPAP
When should you start PPV during a resuscitation?
For HR <100, no respiratory effort, apnea or gasping
During a resuscitation, when should you start compressions?
When HR is <60 and did not improve with PPV or intubation–> then you start cmpressions
What should your initial settings be when prepping for a resuscitation?
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
When do you use MR SOPA, and what does MR SOPA stand for?
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
In general, ET BLADE size you should use for a term infant during a resuscitation
1
Blade size for intubating a preemie
0
00 for micro premie
and 1 for term infant
ET tube size for a term baby
3.5
A baby over 2 kg should get this size ET tube
3.5
use this for babies > 2 kg and/or >34 wks
A baby weighs between 1 kg and 2 kg. Use this size ET tube
3
in general use for gestational age 28 to 34 wks
For an infant weighing <1000 g, use this size ET tube
2.5 (in general is for babies less than 28 wks)
When can you stop compressions?
When HR is above 60
but continue PPV
If you give a NS bolus, how much should the bolus be
10 mg/kg
given over 5 to 10 min
If you give a D10W bolus, how much should it be
2 mL/kg over 2 to 3 min
Early CPAP is for babies under this gestational age
32 weeks
Epi dose
IV: 0.1 mg/kg of 1:10,000
ET: 1 mg/kg
THIS MAY BE WRONG—CLARIFY!!!
How deep should you place ET tube for a baby weighing under 1 km, less than 28 weeks?
6 to 7 cm
How deep should you place ET tube for a baby weighing between 1 and 2 kg, between 28 and 34 weeks?
7 to 8 cm
How deep should you place ET tube for a baby weighing between 2 and 3 kg, between 34 and 38 weeks?
8 to 9 cm
How deep should you place ET tube for a baby weighing over 3 kg, and over 38 weeks?
9 to 10 cm
Depth of a UAC should be
3 x weight + 9
This should be at T6 to T9
Depth of a UVC should be
1/2 (UAC) + 1
should be right above the diaphragm
ELBW
less than 1 kg
VLBW
less than 1500 g
LBW
less than 2500 g
What is a normal birth weight?
2500 to 4000 g
Normal RR in the NICU
30 to 60
Define apnea
No breathing for over 20 seconds, OR, over 20 seconds but with bradycardia or desats
Mean arterial pressure should be roughly greater than or equal to
PMA
If PMA is 27 weeks, MAP should not be below
27
What is a normal Hb at birth?
13.5 to 22
In Hct, this is 42 to 60
At 15 days to 1 mo, what is a normal Hb?
10 to 20
In Hct, this is 31-55
What is a normal WBC at birth?
9 to 34
At 8 days of life, what is a normal WBC?
5 to 21
What is a normal Hb nadir and when does it usually happen?
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 .
