05 EMOC & SAB
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1) High maternal mortality rates remain unchanged despite interventions, so more effective strategies like Skilled Attendance at Birth (SAB) and Emergency Obstetric Care (EmOC) are needed. 2) SAB and EmOC can work together, with SAB preventing issues during labor and birth and EmOC providing timely treatment for complications to save lives. 3) Providers need training to build capacity for SAB and be ready to promptly assess, resuscitate, and manage emergencies like bleeding, shock, and airway issues under EmOC.
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Neonatal resuscitation guidelines 2015
The document summarizes new additions and guidelines in neonatal resuscitation based on recent evidence. Key points include: recommending delayed cord clamping for term and preterm infants; maintaining normothermia between 36.5-37.5°C; using low oxygen (21-30%) for resuscitating preterm infants under 35 weeks; considering CPAP initially over intubation for respiratory distress in preterm infants; and structuring educational programs to teach resuscitation every 6 months for better performance and confidence.
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1) Approximately 10% of newborns require some assistance with breathing right after delivery, while 1% require extensive resuscitation. Preparation for high-risk deliveries is key to successful outcomes.
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3) If meconium is present, the provider should suction the mouth and nose before delivering the shoulders, and may need to intubate and suction if the infant is depressed. Medications like epinephrine may be needed if the heart rate is low after ventilation and chest compressions.
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2. Effective ventilation is the most important part of neonatal resuscitation. Bag-mask ventilation should be performed if the heart rate is less than 100 beats per minute or if the infant has apnea or gasping respiration.
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3) Using pulse oximetry more to guide oxygen use and titrate to target saturation ranges.
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1. Neonatal resuscitation is required for approximately 10% of newborns, with 1% needing major intervention. Preterm infants are at higher risk of requiring resuscitation.
2. Effective ventilation is the most important part of neonatal resuscitation. Bag-mask ventilation should be performed if the heart rate is less than 100 beats per minute or if the infant has apnea or gasping respiration.
3. Chest compressions are performed if the heart rate remains below 60 beats per minute after 30 seconds of effective bag-mask ventilation with 100% oxygen. Compressions are done at a 3:1 ratio with ventilations at 90 compressions per minute.
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1) Simplifying the initial assessment of need for resuscitation from 4 questions to 3.
2) Emphasizing routine care practices like providing warmth and placing the baby skin to skin.
3) Using pulse oximetry more to guide oxygen use and titrate to target saturation ranges.
4) Recommending starting resuscitation with room air rather than 100% oxygen for term babies.
5) Suggesting therapeutic hypothermia for infants with moderate to severe hypoxic ischemic encephalopathy.
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1. Newborn resuscitation is critical to prevent the 4 million newborn deaths that occur annually, nearly all due to preventable conditions like prematurity, infection, and perinatal hypoxia.
2. Proper newborn resuscitation follows the ABCs - clear the airway, establish breathing, and maintain circulation. It requires anticipating need at every birth and having equipment ready like a self-inflating bag, masks, and suction device.
3. Steps include drying, positioning, suctioning if needed, and tactile stimulation followed by ventilation if not breathing. If the heart rate is slow, initiate chest compressions and provide medications like epinephrine if needed. Maintaining
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This document discusses asphyxia of the newborn, including its definition, etiology, clinical features, assessment, management, and complications. Asphyxia is defined as a combination of hypoxemia, hypercapnia, and metabolic acidemia. It can be caused by various maternal and fetal conditions as well as complications during labor and delivery. Clinical features may include abnormal fetal heart rate patterns, low Apgar scores, and signs of organ damage. Assessment involves Apgar scoring, umbilical cord blood gases, and neurological examination. Management follows the ABCDE resuscitation steps and may include ventilation, cardiac compression, drugs, and treatment of complications such as brain injury, respiratory distress, and multiple organ failure.
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Emergency obstetrics is a scientific approach with the positive mindset of the obstetrician and allied team,
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Assessment And Managment Of Critically Ill Child 1
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Essentials of new born care
The document provides information on essential newborn care. It discusses components of essential newborn care including warmth, skin-to-skin contact, breastfeeding, cord care, eye care, vitamin K administration and immunization. It also discusses the Apgar score system used to evaluate newborns and outlines steps for newborn resuscitation. Additionally, it covers topics like high-risk newborns, respiratory distress syndrome, hypothermia, prematurity and low birth weight.
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Birth asphyxia management
This document provides guidance on managing birth asphyxia through proper newborn resuscitation. Key points discussed include:
1. Preparation for delivery is critical as each birth is an emergency, ensuring proper equipment and staff readiness.
2. Initial resuscitation steps are providing warmth, clearing the airway, drying and stimulating the newborn. Positive pressure ventilation may be needed if breathing does not improve.
3. If the heart rate remains low despite adequate ventilation, chest compressions and medications like epinephrine may be administered to support circulation. Intubation should only be considered in specific situations.
4. Post resuscitation care focuses on monitoring vital signs and providing support until stabilization is achieved.
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This document discusses neonatal resuscitation and the physiologic changes that occur at birth. It covers topics like fetal circulation, oxygenation, the transition at delivery, signs of a compromised newborn, resuscitative steps including providing warmth, clearing the airway, stimulation and ventilation. Positive pressure ventilation techniques like bag-mask ventilation are described. The importance of anticipating resuscitation needs, preparing appropriately, and understanding the heart rate response to determine next steps is emphasized. Maintaining normal body temperature and oxygen saturation targets are also addressed.
BIRTH ASPHYXIA PPT.pptx
Birth asphyxia occurs when a baby fails to breathe at birth and can lead to neonatal mortality. It is caused by factors that obstruct breathing such as meconium aspiration or complications during delivery. Symptoms may include abnormal skin tone, lack of crying, and low heart rate. Diagnosis involves assessing signs, using the Apgar score, and determining acid-base balance. Treatment involves clearing the airways, stimulating breathing, warming the baby, and providing ventilation and oxygen as needed. Nursing care focuses on resuscitation and monitoring for complications like brain damage or developmental delays. While immediate effects include acidosis and respiratory issues, long-term effects of severe asphyxia can be cerebral palsy, intellectual disability, or
Hospital care for children who
This document provides guidelines for the management of common childhood illnesses in hospital settings. It includes information on triaging sick children, assessing for emergency conditions, performing emergency treatments, monitoring patients, and administering antimicrobial drugs according to country-specific treatment guidelines. The document emphasizes managing major causes of childhood mortality such as newborn problems, pneumonia, diarrhea, malaria, meningitis, and severe malnutrition.
Unit 2. ANC (2).pptx
- Lie: Longitudinal
- Presentation: Vertex
- Position: Left occipito-anterior
3. Auscultation:
- Fetal heart sound: Rate, rhythm, location
- Fetal movement: Frequency, type
- Uterine contraction: Strength, frequency
4. Vaginal examination:
- If necessary to confirm presentation, position, engagement
Unit 2. ANC (2).pptx
This document discusses antenatal care and focused antenatal care. It outlines the objectives of antenatal care including screening for issues, managing complications, and planning for delivery. Minor disorders of pregnancy like nausea and vomiting are described. The World Health Organization's recommendation of 4 antenatal visits is presented. Key aspects of focused antenatal care assessments are defined, including calculating the estimated due date and birth preparedness.
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Essential core for newborn baby and neonatal resuscitation
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05 EMOC & SAB
- 1. EmOC & SAB : HOW THEY FUNCTION DR. MD. ALAUDDIN PROF. & HEAD G & O MMC
- 2. Why SAB & EmOC? Alarmingly high maternal mortality and morbidity has remained relatively unchanged over the years in spite of various interventions Need to look for more effective intervention strategies
- 3. MMR SCENARIO MMR: not reducing at desired rate Maternal death: due to complications - not predictable/preventable Most deaths: intra partum/immediate postpartum Past interventions: not very successful Experience from other countries/states: evidence
- 5. Precaution -Birth preparedness & complication readiness
- 6. Interventions - Safe & quality care in child birth and timely recognition & effective treatment of complications
- 9. Obstetric and Midwifery Practice 8 A Culture of Quality Care :Good quality care saves life, time and money Team responsibility of Providers Timely action
- 10. Emergency Readiness Maternal deaths are due to some obstetric complications most of which occur suddenly and without warning. There are three delays (3 Ds) which may be operative in preventing women in crisis getting timely treatment or care If untreated, death would occur on an average in: 2 hours from PPH 12 hours from APH 2 days from obstructed labour 6 days from infection
- 11. Rapid initial assessment A quick check (evaluation) of a woman’s condition (especially of vital signs) when she presents with a problem to rapidly assess her degree of illness and identify / exclude any serious condition which needs immediate intervention
- 12. Rapid initial assessment (contd.) Assess - Airway and breathing - Circulation - Unconsciousness/convulsion - Vaginal bleeding
- 13. Adult Resuscitation Shout for help to urgently mobilize personnel in such situation. If she is conscious, reassure her and explain. Check vital signs: (look, feel & listen) Turn her onto her side to ensure open airway (especially if unconscious). Clear nasopharynx if needed. Give oxygen (6-8 litres /min) by mask / nasal cannula. If not / poorly breathing – assist ventilation Mouth to mouth respiration - Bag and mask ventilation - Endotracheal intubation and ventilation by Ambu bag
- 15. raise the foot end.
- 18. Management: - Shout for help Oxygen inhalation (6 – 8 litres/min). Ensure patent airway (turn onto her side). Raise foot end. Keep the woman warm. Rapid infusion: RL/NS to restore B.P Inj. Morphine Steroid: Inj. Hydrocortisone Catheterize bladder Monitor vital signs for evidence of improvement. Refer / manage the specific cause for shock
- 19. Thank you