Transcript Neonatal Resuscitation

Neonatal Resuscitation
-BLSRC 290
Equipment Needed
Overhead radiant warmer
Bulb syringe
BVM with heated &
humidified O2
De Lee suction device
Size 5 Fr suction catheters
and wall suction
Laryngoscope with proper
sized blades
Proper sized ET tubes
Crash cart/Drug box
Normal Delivery Procedures
Place under warmer and
towel dry
Use bulb syringe to clear
mouth, than nose
Tactile stimulation if not
breathing yet
Auscultate heart and lungs &
assess color
Prophylactic silver nitrate or
erythromycin drops in eyes
Vitamin K injection
Examine umbilical cord
Free flow O2 as needed
Free Flow O2
Hold O2 connecting tubing ½ inch from infants face.
Run flow at 5 LPM
Resuscitation
Maternal causes:
– Drugs
– Cardiopulmonary
problems
– Infection
– Dystocia
– Utero-Placental problems
Fetal Causes
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Cord compression
Prematurity
Congenital anomalies
Multiple pregnancy
Meconium aspiration
Hypothermia
shock
NRP Resuscitation Algorithm
Meconium Baby
Airway is aggressively
cleared prior to drying if
infant is meconium stained
AND baby is NOT vigorous!
– Use ET tube as a suction
device
May need PD & P after heart
rate, respirations, and color
stabilize
If baby is meconium stained
but vigorous, proceed with
normal resuscitation
Bagging a Neonate
BVM Devices
BVM Devices
Flow-dependent anesthesia bag
Bagging Technique
Place infant in “sniffing”
position by placing a
small towel under the
shoulders
Do not hyperextend
neck!
Bagging technique (cont.)
Apply correctly sized
mask over infants mouth
and nose with apex of
mask over bridge of nose
Run either type of bag at 5-8
LPM to get 100% FIO2
– If self-inflating bag, use
reservoir also
Watch for slight rise of chest
(Vt ~ 20-30 ml)
Rate is 40-60
Pressure
– First breath may require 30-40
cmH2O
– Then, with normal lungs, 15-20
cmH2O
– Poor lung compliance may
require sustained 20-40
cmH2O
If BVM ventilation lasts over 2
minutes…
Than an orogastric tube has to be
inserted
Neonatal PD & P
Meconium babies and/or
C section babies
No more than 20
degrees of
Trendelenberg or ICP will
increase
Percuss anterior and
lateral surfaces 1-2
minutes
Maintain airway
throughout using one
hand on head
Suction PRN
Besides suction, need
BVM and O2
Monitor heart rate,
respirations and color
throughout
Neonatal PD & P Percussors
Neonatal Chest Compressions
Asystole or bradycardia less than 60 that is not increasing with
airway and ventilation
Use thumbs on lower half of sternum (one finger’s width below
nipple line)
Compress ½ to ¾ of an inch, 120 times per minute
Compression ventilation ratio is 3:1 (pause to give breath)
The End Result