Resuscitation of a newborn Flashcards
what factors stimulate the newborn to breath at birth
- clamping of the cord
- tactile stimulation
- cooler environments
what factors help the baby to clear the fluid in the lungs at brith
- surge in endogenous steroids and catecholamines during labour.
- apnoea and poor respiratory efforts may be a result of poor fluid clearance. and +- C/S
when does the ductus arteriosus close
- when there is increase in oxygen levels in the babies blood.
- there is increase in arterial oxygenation tension which leads to vasoconstriction of the D.A
the closure of the D.A is to allow more blood to flow through the lungs,
what causes closure of the foramen Ovale
clamping of the umbilical cord
- this will cause the low resistance placenta to be removed from the systemic circulation allowing for left side pressures to increase.
- this causes the F.O to close and blood that previously shunted form right to left will now flow through the lungs.
what are some of the factors that affect oxygenation
- amount of air reaching the alveoli
- blood flow through the capillaries in the lungs.
What are the risks of vigorous suctioning
- vagal bradycardia
- laryngospasm
- delay onset of respiration
Consequences of Hypothermia
- Depletion of surfactant
- Hypoxia
- Hypoglycaemia
- Metabolic disorders
- Increased caloric usage
- Acidosis
- Increased neonatal morbidity
infection
Early Onset Sepsis < 72hrs age
- Group B Strep
- Gram Negative Organisms
- Ampicillin/Gentamycin
Late Onset Sepsis > 72hrs age
- Gram Negative
- Group B Strep
- Fungal Infection
- staph aurea
- klebsialla
- pseudomonas
- Treat according to local sensitivity profile
When to suspect failure of PDA closure
Suspect if:
murmur,
collapsing/bounding pulses,
tachycardia
respiratory distress,
cardiac failure
treatment of failure of the closure of PDA
Treatment:
Not all patients with PDA need treatment
- Restrict fluid Total (120ml/kg/day)
- Oxygenate (Sats targeted!)
- Antifailure treatment when indicated (Diuretics)
- NSAID
- Surgical Ligation if severe and NSAID failed
What are the types of apnoea
central apnoea
obstructive apnoea
mixed apnoea
central apnoea
due to absence of respiratory drive
obstructive apnoea
due to airway obstruction or collapse despite continued respiratory effort
mixed apnoea
persisting airway obstruction leads to CNS depression due to hypoxia and acidosis resulting in mixed apnoea
grades of IVH
Grade I - bleeding occurs just in the germinal matrix
Grade II - bleeding also occurs inside the ventricles.
Grade III - ventricles are enlarged by the blood.
Grade IV - there is bleeding into the brain tissues around the ventricles.
