week #6 neonatal resus Flashcards
80% of underweight births need resus ( t/f)
true
what are some antepartum factors that can cause need for neonatal resus?
prenatal care, multiple gestations, mom age ( <16/>35), Hx of prenatal morbidity, drugs/meds, HTN/diabetes etc.
what are some intrapartum factors that can cause need for resus?
prolapsed cord, meconium pressence, onset of labour
What dose antepartum mean?
before labour induction
what does intrapartum factors mean?
onset of labour–> placental delivery
what should be done prior to delivery?
optimize mother O2
what should be done before warm, dry , stimulate?
clean off meconium, suction mouth first then nose id meconium present in a/w.
how should a neonates a/w be positioned?
with towel rolled under their shoulders w head hanging a little bit. to align their trachea
what does PPV do for neonates during resus?
expands the lungs, in creases PaO2 in the arterioles and moves fluid from the lungs to the vasculature supporting adequate cardiac output.
primary apnea and what is done for it?
tachypnea that is followed by a pause in breathing.
warm, dry, & stimulate for baby to start breathing again
secondary apnea and what is done for it?
after primary apnea baby gasps and stops breathing again. PPV baby will no breath on own even with stimulating
what are the s/s indicating for infant PPV?
Hr<100bpm, apnea or gasping, persistent central cyanosis, flaccid, resp distress
size of infant bvm? and how much vol do neonates need?
200-700ml. 15-25ml.
new born resuscitation indications
new born pt
conditions for newborn resus
PPV
age<24hrs
hr<100bpm
CPR
age <24hrs
Hr<60bpm
Other: 30 sec of ppv using Ra
contraindications:
ppv & CPR
- obviously dead or gestation<20 weeks
if your newborn pt has a rr and hr<100bpm what do you do?
30 sec of PPV ra
if your newborn pt hr and rr is <60 bpm what do you do?
30 sec of compression and PPV with 100% O2
If the newborn baby has no muscule tone, no breath or cry what are you to do?
warm, dry and stimulate, clear a/w and warm baby for 30 sec then evaluate rr & Hr
if the baby Hr and rr is >/= 100bpm after resus what can you do?
give baby to mom.
what are the clinical considerations for Neonatal resus?
- is resus is required initiate cardiac monitoring and right hand pulse oximetry
- if u can’t confirm the gestational age initiate resus and transport
- if newborn is <20 weeks resus is futile, provide warms and patch to bhp
what is the target SPO2 aeach min following birth?
1min= 60%-65%
2mins= 65%-70%
3mins=70%-75%
4mins= 75%-80%
5mins= 80%-85%
10mins= 85%-95%
how should you evaluate Hr?
apical (palpate with fingers) or auscultate.
when should apgar scores be done?
1min, 5min, 10min post birth
what is APGAR
A- appearance
P- pulse
G-grimmace
A- activity
r- respirations
If a baby has a strong cry with acrocyanosis, flexed limbs and prompt response to stimulus & Hr<100bpm… what is the APGAR
8
If the baby has Central cyanosis, No activity, no cry/rr, floppy, <100bpm
1
blue grey core is a score of what for appearance?
0
acrycyanosis only is what score for apperance?
1
Pink is what score for appearance?
2
pulse <100= what score
1
pulse >/=100bpm = what score
2
no pulse = what score?
0
a floppy grimace is what score?
0
minimal response is what score for grimace?
1
baby w prompt response to stimulus= what score for grimace?
2
baby with no activity= what score
0
baby w flexed limbs= what score
1
baby thats active= what score
2
baby w no respirations= what score
0
baby with slow & irregular resps= what score
1
baby w active vigorus cry= what score?
2
