NRP Flashcards
FiO2 for infants >35%
21%
FiO2 for <35 qwwka
21%-30%
what laryngoscope size for ifant + preterm
1 for term
0 for preterm
self inflating bags
what is it> what ca’t it allow
- fills spontaneously, remains inflated until squeezed
- can’t provided CPAP or Free flow O2
flow inflating bag
- fills when gas there is seal
T piece
- direct compressed gas to the baby
PEEP
5
PIP
20/25
gradually increase if needed. by 5-10 max is 40
how infant transitions to extrauterine to circulation
First breath, cord clamping
- Low pulmonary vasc resistance
- high systemic vascular resistance
when does the foramen ovale close + PDA
increase in left sided atrial pressure exceeds the right sideed atrial pressure FO closes
- with ventilation, theres an increase in concentration of O2 and decrease in prostaglandins causing closure ofr the PDA over 12-24 horus
asphyxia
not enought tissure perfusion to meet metabolic demands of the tissues for oxygen and waste removal.
S/sx: progressive hypoxemia, hypercarbia, and acidosis
Apnea
primary + secondary
Primary: when RR stops after a brief period of rapid breathing. Causing low HR and decrease tone. Gasping then starts
Secondary apnea occurs after the last gasp. Will need assisted ventilation to have spon respirations (apneic at delivery = secondary)
Cord clamping
standard = clamping for 1-3 minutes after birth for an additional 30-150Ml
- recommond delay 30-60 secs in vigorous term and preterm infants
- immediately clamping the cord in 5-10 secs can result in deficit 25% of normal blood volume
- improve circulation, establish RBC, decrease need for blood transf, lower incidence of NEC + ICH
when does an infant get a polyethylene sheet
<32 weeks
indications for CPAP
labored breathing, unable to maintain O2 within target range despite titrating
PPV
apnea, gasping, HR <100BPM, central cyanosis
heart rate + PPV
HR should increase with 15 secs of PPV
MRSOPA
Mask adjustment, reposition, suction, open, pressure increase, alternative airway
chest comp + intubation
recommended to place ETT prior to start chest conpressure to ensure max ventilation
when do you start Chest compression
fio2 settings
when do you reasses HR
Start if <60BPM after effective 30sec PPV
O2 @ 100%
60secs of effective chest compressions and PPV
BPM, with comp + breaths
90 compressure and 30 breaths
epinephrine indications
HR <60BPM after 30 sec effective PPV + 60 sec effective PPV and chest compressions with 100% FiO2
how does epi work
increases HR + strength of cardiac contractions, vasoconstrictor, increase coronary artery perfusion
Epi dosing of ETT
0.5-1 ml/KG
epi dosing for IV
0.1-0.3 mL/kg
epinephrine concentration
1:10.000 = 1 g into 10000mL of fluid
how often can you repeat epi
3-5 minutes
when do you check HR after first dose of epi
1 minutes after first dose
fluid loss suspicion
NS - 10mL/kg through the UVC
when to reassess HR after ventilation
actions if not incresing HR
15 secs Q15 secs if increasing
if not increasing MRSOPA check chest movement. Once acheived provide 30 secs of PPV
when do you stop PPV
100 BPM
when do you stop chest compressions
HR is >60 BPM
