Resus - Newly born

Question 1

What are the three (3) important things that need to be addressed on assessment of the newly born?

Answer 1

• Tone
- not moving, floppy, extended posture = high
chance of resus
• Beathing
- chest recession, or retraction, expiratory
grunting & nasal flaring = difficulty expanding
lungs
• Heart rate **
- determined via auscultation or palpation of
umbilical cord
- birth = 130bpm; ranging from 110-160bpm

Question 2

When presented with persistent apnoea, poor tone & floppiness and HR < 100/min what should be done?

Answer 2

• IPPV with room air @ 40-60/min, reassessing
after 30sec
- between mothers legs prior to clamping &
cutting cord to promote placental shunt
*only if effective & warmth can be maintained

** CPR ONLY if HR < 60bpm/min

Question 3

Under how many weeks is resuscitation futile?

Answer 3

< 20 weeks

Question 4

All newly borns require temperature control. List interventions that can be used.

Answer 4

• Pre-warmed linen
• Drying & swaddling
• Covering with plastic
• Skin to skin contact with mother & covering

• Resus - positioning supine inside plastic bag,
drying head & covering head with corner of
warm blanket

Question 5

What should be considered for pre-term newly borns ( < 37wks) ?

Answer 5

• CCP
• Difficult ventilations due to lung stiffness =
barotrauma
• Rapid heat loss
- put in plastic bag without prior drying & then
dry & cover head
• Increased risk of infection & hypovolaemia
• PEEP - can improve functional reserve capacity

Question 6

When is suctioning indicated & what are the possible consequences?

Answer 6

Only indicated if there is an airway obstruction or if the newly born is birthed through the meconium stained amniotic fluid.

Sectioning can delay oxygenation, cause laryngeal spasm & trauma to soft tissues.
If it is to be done the mouth must be suctioned first, followed by the nose.

Question 7

How long may a healthy new born appear cyanosed for?

Answer 7

Up to 10mins until their SpO2 reaches extra uterine values.
* SpO2 can range from 68% - 97%

If central cyanosis persists > 10mins commence 02 @ 2 LPM until centrally pink

Question 8

After initial 30sec of IPPV on room air & HR 60-100/min what do you do?

Answer 8

• Continue IPPV with 02 @ 15ml/min

* Reassess after 30sec

Question 9

What is the CPR ratio for newly borns?

Answer 9

3:1

90 compressions & 30 ventilations / min