1 / 38

NEWBORN RESUSCITATION

NEWBORN RESUSCITATION. Belen Amparo E. Velasco, M.D. ASSESS AND SUPPORT. TEMPERATURE (warm and dry) ABC’s AIRWAY (position and suction) BREATHING (stimulate to cry) CIRCULATION (heart rate and color. INVERTED PYRAMID In NB Resuscitation.

blue
Télécharger la présentation

NEWBORN RESUSCITATION

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. NEWBORN RESUSCITATION Belen Amparo E. Velasco, M.D.

  2. ASSESS AND SUPPORT • TEMPERATURE (warm and dry) • ABC’s • AIRWAY (position and suction) • BREATHING (stimulate to cry) • CIRCULATION (heart rate and • color

  3. INVERTED PYRAMID In NB Resuscitation Dry, Warm, Position, Suction, Stimulate Oxygen Establish effective ventilation Chest Compression Medications

  4. PREPARATION • ADVANCED PREPARATION • IMMEDIATE PREPARATION

  5. ADVANCED PREPARATION • OBSTETRICAL TRAY • NB RESUSCITATION TRAY • RADIANT WARMER/DROPLIGHT

  6. NB RESUSCITATION EQUIPMENT • Bulb syringe • Endotracheal tube (2.5, 3.0, 3.5) and stylets • Face masks and ambubag • Feeding tubes • Gowns, gloves, goggles • Heat source • Laryngoscope handles and blades • Meconium aspirator • Medications and fluids • Sterile UC set • Suction with manometer/catheters • Syringes (1, 3, 10 and 20 ml) • Warmed blankets

  7. IMMEDIATE PREPARATION • BASED ON RESUSCITATION • -ORIENTED HISTORY • VERIFICATION OF AIRWAY • PATENCY AND PLACEMENT • OF VASCULAR CATHETERS

  8. RESUSCITATION-ORIENTED HISTORY • MECONIUM STAINING • PREMATURITY • TWIN PREGNANCY • NARCOTICS ADMINISTRATION • TO MOTHER

  9. FACTORS ASSOCIATED WITH INCREASED RISK FOR NEONATAL DEPRESSION • ANTEPARTUM MATERNAL FACTORS • INTRAPARTUM MATERNAL OR • FETAL FACTORS

  10. ANTEPARTUM MATERNAL FACTORS • Maternal age > 35 or < 18 • Chronic and pregnancy-induced HPN • Diabetes • Hemorrhage • Drug therapy (Mg, lithium, adrenergic-blockers • Substance abuse • Previous abortion • No prenatal care • Anemia or isoimmunization

  11. ANTEPARTUM MATERNAL FACTORS • Maternal illness (CV, thyroid, • neurologic) • Multifetal gestation • Small fetus for maternal dates • Post-term fetus • Preterm labor or PROM • Immature pulmonary studies • Oligohydramnios • Diminished fetal activity • Fetal malformation by UTZ

  12. INTRAPARTUM MATERNAL OR FETAL FACTORS • Breech or other abnormal presentation • Infection • Prolonged labor • Prolonged rupture of membranes • Prolapsed cord • Maternal sedation • Operative delivery • Meconium-stained AF • Indices of fetal distress

  13. UNIVERSAL PRECAUTIONS • GLOVES AND OTHER APPROPRIATE • PROTECTIVE BARRIERS (gowns and • goggles) • SUCTION EQUIPMENT SHOULD • ALWAYS BE AVAILABLE

  14. INVERTED PYRAMID In NB Resuscitation Dry, Warm, Position, Suction, Stimulate Oxygen Establish effective ventilation Chest Compression Medications

  15. INITIAL STEPS OF RESUSCITATION (20 seconds) • PREVENTION OF HEAT LOSS • PROPER POSITIONING • SUCTIONING • TACTILE STIMULATION

  16. TEMPERATURE REGULATION • HEAT LOSS MAY BE PREVENTED BY • REMOVING WET LINENS • DRYING THE BABY • PLACING INFANT UNDER • PREHEATED LAMP/RADIANT • WARMER

  17. TEMPERATURE REGULATION • ALTERNATIVE METHODS OF WARMING: • WARM BLANKETS/TOWELS • WARM MATTRESSES

  18. AIRWAY POSITIONING • PLACEMENT ON BACK OR SIDE WITH • NECK IN NEUTRAL POSITION • SHOULDER ROLL (3/4 OR 1 inch) to • EXTEND NECK SLIGHLY

  19. AIRWAY SUCTIONING • IF MECONIUM-STAINED, TRACHEAL • SUCTIONING • BULB SYRINGE SHOULD BE ADEQUATE • IF NOT MECONIUM-STAINED, • SUCTION MOUTH FIRST THEN • NOSTRILS

  20. AIRWAY SUCTIONING • MAY USE MECHANICAL SUCTION • WITH 8F OR 10F SUCTION • CATHETERS AT NEGATIVE • PRESSURE NOT TO EXCEED • -100mmHg FOR NO LONGER • THAN 3 to 5 seconds PER • ATTEMPT

  21. TACTILE STIMULATION • SLAPPING OR FLICKING THE SOLES • GENTLE RUBBING OF THE BACK

  22. ASSESSMENT • RESPIRATORY EFFORT • HEART RATE • COLOR

  23. INVERTED PYRAMID In NB Resuscitation Dry, Warm, Position, Suction, Stimulate Oxygen Establish effective ventilation Chest Compression Medications

  24. OXYGEN • 100% OXYGEN SHOULD BE USED • PREFERABLY WARMED AND • HUMIDIFIED • FREE-FLOW O2 BY O2 HOOD • OR BY FACE MASK ATTACHED TO • AMBUBAG OR SIMPLE MASK • HELD TO FACE WITH 5L/min O2 • FLOW

  25. INVERTED PYRAMID In NB Resuscitation Dry, Warm, Position, Suction, Stimulate Oxygen Establish effective ventilation Chest Compression Medications

  26. POSITIVE-PRESSURE VENTILATION • INDICATIONS • APNEA OR GASPING RESPIRATION • HEART RATE LESS THAN 100 bpm • PERSISTENT CENTRAL • CYANOSIS 100% OXYGEN

  27. POSITIVE-PRESSURE VENTILATION • USUALLY PROVIDED WITH BAG • AND MASK • VENTILATORY RATE of 40-60/min

  28. INVERTED PYRAMID In NB Resuscitation Dry, Warm, Position, Suction, Stimulate Oxygen Establish effective ventilation Chest Compression Medications

  29. CHEST COMPRESSION INDICATIONS Persistent bradycardia (60-80/min not increasing) despite 30 seconds of positive pressure ventilation

  30. CHEST COMPRESSION • CHEST COMPRESSION AT A RATIO with BAGGING OF 1:3 (Total of 120 events) • TWO METHODS: • Thumb method • Two-finger method

  31. INVERTED PYRAMID In NB Resuscitation Dry, Warm, Position, Suction, Stimulate Oxygen Establish effective ventilation Chest Compression Medications

  32. MEDICATIONS EPINEPHRINE INDICATIONS Heart rate of zero Persistent bradycardia (<60/min) despite 30 seconds of positive pressure ventilation and 30 seconds of chest compression

  33. MEDICATIONS VOLUME EXPANDERS INDICATIONS Acute blood loss Non-improvement despite adequate resuscitation

  34. MEDICATIONS SODIUM BICARBONATE INDICATIONS Documented metabolic acidosis Cardiac arrest

  35. MEDICATIONS NALOXONE INDICATIONS Respiratory depression with maternal history of narcotic intake within four hours from the time of delivery

More Related