8. L aryngeal M ask A irway New NRP Adjuncts to Respiratory Care CO 2 Detector T-Piece Resuscitator
9.
10. Epinephrine Administration Concentration = 1:10,000 Preferred route is IV but give first dose endotracheally while IV is obtained. Dose IV = 0.1 ml/kg Dose Endotracheal = 1.0 ml/kg Administration Rate = rapidly AAP Canadian Addendum
Editor's Notes
Why is there a difference between recommendations in the text and Canadian recommendations? National guidelines to neonatal resuscitation across several continents are based on the consensus statements of the International Liaison Committee on Resuscitation (ILCOR). Each country is expected to develop guidelines that reflect their own context. Similarities between the American healthcare system and our own have fostered a strong and fruitful relationship with the American NRP Committee, permitting us to have input into development of the AAP NRP guidelines and textbook and to base our neonatal resuscitation education on the Neonatal Resuscitation Program. However, on occasion, we have felt this relationship constrains the development of guidelines specific to Canadian institutions in the absence of a Canadian textbook. The National NRP Committee for Canada has, therefore, felt that we should identify and promote approaches to resuscitation which have been interpreted by Canadian clinicians, scientists and educators to reflect our own unique healthcare system and culture, just as the AAP NRP guidelines are on occasion constrained by the American healthcare system. This philosophy is key to the growth of our neonatal community, but its consequence will be, on occasion, a disparity between practices north and south of the border.
Research has consistently shown that it can take up to 3 minutes for infants colour to change post delivery The Baby who does not require resuscitation gets ROUTINE CARE : provide warmth, clear airway, dry and colour is assessed there this is normally in while in moms arms
This may be what is adapted for our cardiac patients who due to there lesions
THESE NEW RESUSUCIATION RECORDS MAY APPEARR IN MORE PATIENTS CHARTS AS THEY ARE IMPLEMENTED IN THE GTA Tick box resuscitation section may assist a clinicians understanding of the patients initial resuscitation required and interventions taken
The laryngeal mask airway has been shown to be an effective alternative for assisting ventilation when positive-pressure ventilation is ineffective and attempts at intubation are not feasible or are unsuccessful. LMA s will eventually be kept in RT special airway box as well as a few C02 detectors We will not have the T piece resuscitator as we have self-inflating bags with peep clamps and blenders and manometers at every bedside
Neither ILCOR or AAP make recommendations for use of PEEP or CPAP during resuscitation, although it is referred to. The CPS felt that a PEEP of 0 cmH2O is potentially harmful and therefore made the above recommendations.
ILCOR and AAP NRP 2006 both recommend IV as the preferred route of Epi administration, and both consider giving a dose that is 10X greater if given via the ETT. Epinephrine should be given by the umbilical vein. The endotracheal route is often faster than placing an umbilical catheter, but is associated with unreliable absorption and may not be effective at the lower dose. If a dose of epinephrine is given via the endotracheal tube while umbilical venous access is being established, consider a higher dose (0.3 mL-1.0 mL/kg) by this route only. Do not give high doses of epinephrine intravenously.
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