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Simulation: Precipitous Delivery & Neonatal Resuscitation Cindy Hsu, MD, PhD February 19th, 2014 Thanks to the West Philly water, you will see one! The Delivery • How to catch the baby • Nuchal cord issues – Wrapped around the neck – Too tight – Prolapse • Delivery of the placenta • Post-partum care http://www.brooksidepress.org/Products/Obstetric_and_Newborn_Care_II/lesson_3_Section_1.htm The Somersault Neonatal Resuscitation First, ask 3 questions: What about the APGAR? Check the HR at 30 sec How do you check the pulse? What kind of air do you use? Check the HR at 1 min Consider meds Don’t forget about hypothermia and hypoglycemia! Remember the targeted O2sat Meconium • If baby is fine, perform routine care • If patient is under distress, perform deep suction using an ETT and meconium aspirator Intubation ETT LMA: Size 1 is suitable for infants up to 5kg Blade Size 1 for term infants Size 0 for premature infants Size 00 for extremely low birth weight infants Access • IO • Umbilical lines Medications • Epinephrine – 0.1 to 0.3mL/kg of 1:10,000 (10-30 mcg/kg) – Can repeat q3-5min if HR < 60 • Glucose – 2mL/kg of D10W • Fluid – 10cc/kg NS over 5-10 minutes, can give 2nd dose Questions? Helpful videos • http://www.youtube.com/watch?v=hQnKT-moeY • http://academiclifeinem.com/patwariacademy-videos-neonatal-resuscitation/ • http://www.brooksidepress.org/Products/O bstetric_and_Newborn_Care_II/lesson_3_ Section_1.htm