Transcript Slide 1

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