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Neonatal Resuscitation

Neonatal Resuscitation. -BLS- RC 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.

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Neonatal Resuscitation

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  1. Neonatal Resuscitation -BLS- RC 290

  2. 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

  3. 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

  4. Free Flow O2 Hold O2 connecting tubing ½ inch from infants face. Run flow at 5 LPM

  5. Maternal causes: Drugs Cardiopulmonary problems Infection Dystocia Utero-Placental problems Fetal Causes Cord compression Prematurity Congenital anomalies Multiple pregnancy Meconium aspiration Hypothermia shock Resuscitation

  6. NRP Resuscitation Algorithm

  7. 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

  8. Bagging a Neonate

  9. BVM Devices

  10. BVM Devices Flow-dependent anesthesia bag

  11. Bagging Technique • Place infant in “sniffing” position by placing a small towel under the shoulders • Do not hyperextend neck!

  12. Bagging technique (cont.) • Apply correctly sized mask over infants mouth and nose with apex of mask over bridge of nose

  13. 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

  14. If BVM ventilation lasts over 2 minutes… Than an orogastric tube has to be inserted

  15. 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

  16. Neonatal PD & P Percussors

  17. 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)

  18. The End Result

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