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Resuscitation enc-3
Resuscitation enc-3
Resuscitation enc-3
Resuscitation enc-3
Resuscitation enc-3
Resuscitation enc-3
Resuscitation enc-3
Resuscitation enc-3
Resuscitation enc-3
Resuscitation enc-3
Resuscitation enc-3
Resuscitation enc-3
Resuscitation enc-3
Resuscitation enc-3
Resuscitation enc-3
Resuscitation enc-3
Resuscitation enc-3
Resuscitation enc-3
Resuscitation enc-3
Resuscitation enc-3
Resuscitation enc-3
Resuscitation enc-3
Resuscitation enc-3
Resuscitation enc-3
Resuscitation enc-3
Resuscitation enc-3
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  • Newborn Resuscitation Algorithm.
  • Transcript

    • 1. RESUSCITATION OF THE NEWBORN BABY
    • 2. Why we need to resuscitate: pH 7.30 pH 7.00 pH 6.80
    • 3. How often do we use our resuscitation skills?
    • 4. PREPARING FOR BIRTH Wash your hands  Draught free, warm room - temperature >250C  Clean, dry and warm delivery surface  Radiant heater  Two clean, warm towels/clothes  A folded piece of cloth  Self inflating bag - newborn size  Infant masks in two sizes - normal and small newborn  Suction device  Oxygen (if available)  Clock Check if all equipments are in working order
    • 5. ASSESSMENT AT BIRTH  Deliver the baby on to mother’s abdomen  Note and call out time of birth  Thoroughly dry the baby  Use a warm towel  Discard wet towel after drying  Wrap the baby in another warm cloth Keep the baby warm Assess breathing while drying 5
    • 6. CARE OF THE BABY AT BIRTH Assess breathing: Assessment Baby is crying Decision Baby is not crying, but breathing at 30 to 60 times per minute Baby is gasping No need for resuscitation or suctioning; Start skin-to-skin contact and breastfeeding No need for resuscitation or suctioning Start resuscitation immediately Baby is not breathing Start resuscitation immediately H- 6
    • 7. Newborn Resuscitation Algorithm. Kattwinkel J et al. Pediatrics 2010;126:e1400-e1413 ©2010 by American Academy of Pediatrics
    • 8. Dry the baby immediately after birth Immediate skin-to-skin Contact & Breastfeeding (routine care) 8
    • 9. Steps of resuscitation If the baby is not breathing or gasping ◦ Call for help! ◦ Cut cord quickly, transfer to a firm, warm surface [under a radiant heater] ◦ Inform the mother that baby has difficulty breathing and you will help the baby to breathe ◦ Start newborn resuscitation 9
    • 10. Suction Equipment Warmer & Blankets Bag, Mask, & Oxygen Laryngoscope and ETT Tube
    • 11. Steps of resuscitation Position 11
    • 12. Steps of resuscitation Position, clear airways (if needed) Suction: Do not exceed duration of 20 sec 12
    • 13. Steps of resuscitation Dry, stimulate, reposition 13
    • 14. Steps of resuscitation Dry, stimulate, reposition 14
    • 15. Steps of resuscitation Ventilate (if still not breathing) Selecting Bag & Mask equipment • Size of bag: 240-750 ml • Oxygen capability: Oxygen source, reservoir • Safety feature: Pop off valve, pressure gauge (optional) 15
    • 16. Steps of resuscitation Ventilate Use the CORRECT size face mask that covers:  The nose  The mouth  The tip of the chin but not the eyes 16
    • 17. Steps of resuscitation Fitting a face mask: • A face mask that is too LARGE – Covers the eyes – Extends over the tip of the chin • A face mask that is too SMALL – Does not cover the nose – Does not cover the mouth effectively 17
    • 18. Steps of resuscitation Ventilate  Squeeze bag with 2 fingers or whole hand, 2-3 times  Observe for rise of chest  IF CHEST IS NOT RISING: ◦ Check seal ◦ Reposition the head ◦ Squeeze harder  Once good seal and chest rising, ventilate at 40 squeezes per minute  Observe chest rise  Check heart rate after 30 seconds 18
    • 19. Steps of resuscitation When to stop ventilating? If baby is crying; If breathing >30/min, and NO chest in-drawing: ◦ If the skin between the ribs is ‘sucked’ inwards and the ribs are prominent, the baby has chest ‘in-drawing’ 19
    • 20. Steps of resuscitation After stopping ventilation  Put the baby in skin-to-skin contact on mother’s chest  Monitor every 15 minutes for breathing and warmth  Tell the mother the baby will probably be well  Encourage the mother to start breastfeeding as soon as possible NEVER leave the baby alone 20
    • 21. Steps of resuscitation When to continue ventilating? If the baby – is breathing at a rate of <30/min, – is gasping – has severe chest in-drawing • Arrange for immediate referral 21
    • 22. MECONIUM STAINED AMNIOTIC FLUID No need for intrapartum suction Birth: assess HR, breathing and tone Vigorous: HR>100 good breathing Nonvigorous: any parameter abnormal Good tone Initial steps Tracheal suction 23
    • 23. Steps of resuscitation Special considerations for preterm • Be gentle • Use small size resuscitation bag and give small tidal volumes to move chest • Avoid 100% oxygen , use blenders and oxygen saturation monitors • Avoid rapid fluid bolus • May need intubation, chest compression, medications 24
    • 24. Post resuscitation management Principles 1. Keeping normal temperature 2. Maintaining oxygenation 3. Maintaining physiological milieu- fluids , glucose 4. Maintaining perfusion 5. Treating seizures 6. Monitoring organ function 25
    • 25. Care after resuscitation • • • • • Place baby in skin-to-skin contact with mother Keep the baby warm Monitor every 15 minutes Start breastfeeding as soon as possible Discuss what has happened with the parents be positive! • Do not separate the mother and baby unless the baby has difficult breathing 26

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