Neonatal resuscitation
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Transcript of Neonatal resuscitation
NEONATAL RESUSCITATION
BY DR SHANZA AUROOJ
WHAT IS NEONATAL RESUSCITATION?Neonatal Resuscitation is
intervention after a baby is born to help it breathe and to help its heart beat.
Before a baby is born, the placenta provides
oxygen and nutrition to the blood and removes
carbon dioxide.
After a baby is born, the lungs provide
oxygen to the blood and remove carbon
dioxide
The transition from using the placenta to using the lungs for gas exchange begins when the umbilical cord is
clamped or tied off, and the baby has its first breath.
Many babies go through this transition without needing intervention.
Some babies need help with establishing their air flow, breathing, or circulation
Neonatal resuscitation is helping the newborn with
AIRWAY BREATHING CIRCULATION
ABC
PREPARATION FOR RESUSCITATION
ANTICIPATIONADEQUATE EQUIPMENTADEQUATE PERSONNEL
EQUIPMENT REQUIREDRESUSCITATION TABLESTERILE LINENSUCTION APPARATUSLARYNGOSCOPEAMBU BAG & FACE MASKSORAL AIRWAYSOXYGEN WITH FLOW METER & TUBINGENDOTRACHEAL TUBESSCISSORS GLOVES
MEDICATIONSEpinephrineNaloxone hydrochlorideVolume expanders
Normal saline Albumin 5% Ringer lactate
Sodium bicarbonate4.2%Dextrose water 10%Sterile water
MISCELLENOUS Radiant warmer Stethoscope Adhesive tape Syringes Butterfly needles Umbilical artery catheterization tray Umbilical catheter 3 & 5 fr Feeding tube Spirit sponges
RADIANT WARMER
AMBU BAG
Newborn life support
Clear of meconiumBreathing or crying?Good muscle tone?Color pink?Term gestation?
Provide warmthPosition (clear airway)Dry,stimulate,repositionGive Oxygen
Evaluate respiration,heart rate & colour
Routine care:•Provide warmth •Clear airway•dry
Provide positive pressure ventilation
Provide positive pressure ventilationAdminister chest compression
Administer adrenaline
Supportive care
Ongoing care
BIRTH
YES
NO
Breathing HR>100 & PINK
APNEA Or HR<100
VENTILATING
HR>100 & PINK HR<60 HR>60
HR<60 HR>60
HOW TO PREVENT HEAT LOSS?
Place the infant under radiant heat source
Dry off the amniotic fluid
What is the correct position?How to clear airway?
Place the newborn in a supine position with neck semi extended,use a shoulder role to keep neck extended
Suction the infant’s mouth and nose
A=AIRWAY
INITIATE BREATHINGUse tactile stimulationEmploy positive pressure
ventilation when necessary usingBag & maskBag & endotracheal tube
Ventilation rate=40/minVentilation pressure=15-
20cm of water Continue ventilation for
15-30 minutes
B=BREATHING
WHAT ARE THE WAYS TO MAINTAIN CIRCULATION?Chest compression=when
HR<60/minSternum should be compressed ½
inch with PPV at the ratio of 3: 1 Encircle the chest with overlapping
thumbs orPlace middle & index finger of one
hand right angle to the chest wall over sternum
Continue for 30 seconds,if HR>60 & increasing stop compressions
C=CIRCULATION
When to use medication?
When HR is not increasing despite adequate ventilation with 100% oxygen & chest compression then use drugs to stimulate heart
ADRENALINE(1:10,000): 0.1-0.3 ml/kg IV, repeated every 3-5 min
Volume expanders(N/S,R/L,5% albumin): 10 ml/kg IV 5-10/min
Sodium bicarbonate:prolonged cardiac arrest 1-2 meq/kg IV
Naloxone hydrchloride: 0.1 mg/k IV,maternal narcotics administration within 4 hours
Dopamine: continued shock,dose=5-20 mg/kg/min,continous
THANKYOU