Neonatal Resuscitation ny Ms. Tanuja, Sister In-Charge, NICU, SVBCH, Silvassa

1. 1 12/9/2020
Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH

2. Definition:
Neonatal
resuscitation is defined as the
set of interventions at the time
of birth to support the
establishment of breathing
and circulation.
Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
2 12/9/2020

3. Incidence
90-95% of babies does not require any
resuscitation at birth
5-10% babies require tactile stimulation
with bag and mask ventilation. simple
resuscitation with light tactile.
<1% of babies require extensive
resuscitation.
Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
3 12/9/2020

4. Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
4 12/9/2020

5. INDICATION
 PRETERM DELIVERY
 DELIVERY OTHER THAN NORMAL
 MALPRESENTATION
 MULTIPLE PREGNANCY
 FETAL DISTRESS
 MECONIUM STAINING
 SEVER IUGR
 ANTEPATUM HEMMORAHAGE
 ANTENATAL DIAGNOSIS OF FETAL
ABNORMALITIES
Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
5 12/9/2020

6. PREREQUISITES
Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
6 12/9/2020

7. RESUSCITATION PLACE
FLAT SURFACE
WARM AND CLEAN
ROOM TEMPERATURE 26-27 DEGREE
CELCIUS
RADIANT WARMER/HEATER/A 200
WATT BULB
KEEP HEAT SOURCE ON BEFORE
DELIVERY
2 PRE WARMED TOWELS TO RECEIVE
THE BABY.
Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
7 12/9/2020

8. EQUIPMENTS
 MUCUS EXTRACTOR
 RADIANT WARMER
 MECHANICAL SUCTION
 FEEDING TUBE
 AMBU BAG WITH MASK
 LARYNGOSCOPE WITH BLADE
 OXYGEN FLOW METER WITH TUBING
 ET TUBE (ALL SIZE)
 STICKINGS (DYNAPLAST)
Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
8 12/9/2020

9. Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
9 12/9/2020

10. RESUCITATION DRUGS
INJ.EPINEPHRINE
INJ.NALAXONE (antidote for
baby of GA mother)
NORMAL SALINE
STERILE WATER
Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
10 12/9/2020

11. GENERAL
MEASURES
WARMTH POSITIONING
CLEAR THE
AIRWAY
STIMULATION EVALUATION
Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
11 12/9/2020

12. Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
12 12/9/2020

13.  APGAR score
 7-10 reassuring condition
 3-7 moderate abnormal
 0-3 immediate resuscitation
10 out of 10 is perfect score
A score over 7 indicates good condition
A score less than 7 may indicate some medical
assistance.
 Description of intervention with time.
Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
13 12/9/2020

14. Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
14 12/9/2020

15. Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
15 12/9/2020

16. Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
16 12/9/2020

17. Procedure
 Apply the mask covering the chin up to the nose
 Resuscitator at the head end or side
 Rate 40-60/min
 If along wit chest compresion,30/min
 Evaluate every 30 sec until HR.100bpm
 If HR,60bpm:start chest compression
 If stomach distended, decompress it with ryles tube.
Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
17 12/9/2020

18. Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
18 12/9/2020

19. Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
19 12/9/2020

20. CORRECTIVE METHOD FOR
EFFECTIVE AIRWAY SUPPLY
M R .S O P A
M=MASK RIGHT SIZE AND FIT
R=REPOSITION,NECK AND MASK
S=SUCTION NOSE AND MOUTH
O=OPEN MOUTH WHILE VENTILATING
P=PRESSURE INCREASE IF NO CHEST RISE
A=ALTERNATIVE AIRWAY(INTUBATION)
Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
20 12/9/2020

21. Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
21 12/9/2020

22. Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
22 12/9/2020

23. Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
23 12/9/2020

24. Rate 100/min
COMPRESSION:VENTILATION
RATIO=3:1
Evaluate HR after 30 sec
Discontinue if HR>60bpm
Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
24 12/9/2020

25. ENDOTRACHEAL INTUBATION
 INDICATIONS
 Meconium aspiration with limp and
apneic
 No response to BMV
 Congenital Diaphragmatic hernia
 When chest compression is done
simultaneously.
 For administration of drugs-Inj.
adrenaline
Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
25 12/9/2020

26. Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
26 12/9/2020

27. No HR for 20 mins
Gestational age ,23weeks
Birth weight,400g
Antenatal USG
1. Trisomy 13(patau syndrome)
2. Trisomy 18 (edwards syndrome)
3. Enencephaly Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
27 12/9/2020

28. MECONIUM STAINED LIQUOR
BABY ACTIVELY CRYING
ONLY suctioning of mouth and nose
BABY DEPRESSED ON DELIVERY
 Avoid initial stimulation
 BMV in resource limited setting
 Endotracheal intubation and suction if HR
falls during suction, give PPV
Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
28 12/9/2020

29. Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
29 12/9/2020

30. Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
30
Neopuff
12/9/2020

31. Shri Vinoba Bhave Civil Hospital, Silvassa,
DNH
31 12/9/2020