Week 11 - neonatal resus Flashcards
how do we want the airway positioned?
head in numeral or slightly extended position
how do we suction the neonates airway?
only suction if obvious blood or meconium
obstruction mouth then nose
use soft 10-12mm catheter with no more than 100mmhg pressure
what are some of the complications of suctioning a neonates airway?
delayed onset of effective breathing
laryngospams and bradycardia
trauma to soft tissue
what are some suctioning considerations?
don’t suction before birth of shoulders
don’t suction if crying/vigorous
what do we do with the BVM for a newborn resus?
drying the infant offend suffienct to stimulate breathing
no shaking, slapping, flicking
if the newborn does not start breathing start BVM
how are ventilations performed for a neonatal resus?
initial ventilation about clearing the lungs
may require higher airway pressure
ventilations provided at 40-60 per minute uw and an inspiritry time of 0.3-0.5 seconds
if after 30 seconds HR <100 then 100% O2 on 5L/min
how do we know if resus/breathing is effective?
increase of HR to over 100
rise and fall of chest
oxygenation of neonate improve
when do compression need to occur?
when HR is <60 despite 30 seconds of breaths
what is the compression ratio for newborn resus
3 to one compressions to 1 ventilation
what are the target SPO2 readings of the neonate?
1 min 60-70 2 min 65-85 3 min 70-90 4 mins 75-90 5 mins 80-90 6 mins 85-90
where should the SPO2 prob be placed on a neonate?
right hand or wrist not left due to the influence of the ductus arterioles on the left side not giving an accurate reading
what are the receiving hospitals for neonates?
mercy, Monash, womens and RCH - infants < 32 weeks, intubated
level 2 public maternity hospital neonates >32 weeks and <37 weeks
what is SIDS?
the sudden and unexpected death of an infant under the age on one year old
what are the inherent risk factors for SIDS?
inherent under 12 months 3-6 months male prematurity multiple birth LBW cold/infection
what are the preventative risk factors for SIDS?
tummy/side sleeping over covered over heating smoking CO2 re-breathing formula feeding
what make up 86% of infant deaths in australia?
perinatal conditions 53% complications of the chord, placenta nd membranes, maternal complications of pregnancy
congenital abnormalities 23%
symptoms and signs of abnormal findings, including sudden infant death syndrome 9.3%
what percentage of babies die from SIDS?
3% death of all infants
what is SUDI?
covers previous SIDS and other fatal sleep accidents
- suffocation while sleeping
inertial child death
causes undetermined
what accounts for the majority of SUDI?
unsafe sleeping environments account for over 90% of SUDIs
- to prevent serious sleep accidents
safe cot
safe mattress and safe bedding
what to do after SUDI?
police must be notified - unexpected death support family offer telephone family offer information on what happens next complete prorate forms notify coroner
what to do after SUDI?
police must be notified - unexpected death support family offer telephone family offer information on what happens next complete prorate forms notify coroner
where should compressions on a newborn be perfomed?
lower third of the sternum
what can MICA do in a neonatal resus?
intubate
adranalin 10mcg/kg IV 4 minutley
if HR <60 despite adranlain and ventialtions then normal saline 10-20ml/kg repate if necissary
what is the preefered acess site in neonatal resus?
umbilicle vein- IV acess difficult
what are some extra things to do with a pre-term or <1500g nenoate?
increase tempreture
place in ziplock bag - dry and cover heds
provide warmth
what apgar score and when in a baby greater than 34 weeks be suggestive of poor outcome?
1-3 after 20 minutes ut with a detectable HR
what does the neumonic mr sopa stand for and assist us with?
adeqaute ventilations in nonatal resus
mask- check fit and size reposition0 aligne head/neck nutral s- suction airway- patency Open mouth by lifting jaw Pressure increases Alternative airway- adjucts an intubation
