1. Neonatal resuscitation involves providing care to newborns who do not transition well from intrauterine to extrauterine life, with 1-3 per 1000 live births requiring interventions like chest compressions or medications. 2. Successful transition at birth depends on significant physiologic changes and within 30 seconds of birth most term newborns will begin breathing on their own. 3. The neonatal resuscitation program follows a standard flow diagram involving initial assessment, clearing the airway, establishing breathing and circulation, and administering any necessary drugs.

1. NEONATAL RESUSCITATION
Mohmmad Almaghayreh
PRTH

2. INTRODUCTION
One to 3 babies per 1000 live births will receive chest compressions or
emergency medications
Successful transition from intrauterine to extrauterine life is dependent upon
significant physiologic changes that occur at birth
Within 30 sec after birth , 85% Term newborns will begin breathing
while additional 10% begin breathing in response to drying and
stimulation

3. Preparing for resuscitation
Chest compressions
Initial steps of newborn care
Positive pressure ventilation
Alternative airways :endotracheal tubes and laryngeal masks
Medications
Summary

4. FETAL CIRCULATION

7. NEONATAL RESUSCITATION
PROGRAM FLOW DIAGRAM
5 Blocks
-Initial assessment
-Airway(A)
-Breathing (B)
-Circulation(C)
-Drugs (D)

8. PREPARING FOR RESUSCITATION

10. RISK FACTORS

11. ASSEMBLE THE RESUSCITATION TEAM
 Every birth must be attended by at least 1 qualified individual
skilled in the initial steps of newborn care and positive pressure
ventilation
 If risk factors are present at least 2 qualified people should be
present solely to manage the baby
Team leader ?
How many members ?

12. PRE-BIRTH QUESTION ?
• 4 Questions:
 What is the expected gestational age?
 Is the amniotic fluid clear?
How many babies are expected ?
 Umbilical cord management plan? (NRP-8th)
 Are there any additional risk factors ?
UPDATE 1: Umbilical cord management plan added to 4 prebirth questions, replacing “ How many babies?

13. ASSEMBLE AND CHECK SUPPLIES
 Warm
 Clear airway
 Auscultate
 Ventilate
Oxygenate
 Intubate
 Medicate

16. THE GOLDEN MINUTE
• Assessment
• Airway

18. INITIAL STEPS OF NEWBORN CARE

19. BIRTH POSITION

20. CLEAR SECRETION FROM AIRWAY (M before N)

21. STIMULATE
• Gently rub the newborns back, trunk or extremities
• Over vigorous stimulation is not helpful and can cause Injury
• NEVER SHAKE A BABY

22. UMBILICAL CORD MANAGEMENT

23. REMARKS
• Delayed cord clamping definition: WHO: 60 seconds ACOG: 30-60
second
• Pros
1. Less intraventricular hemorrhage of any grade
2. Higher blood pressure and blood volume
3. Higher hemoglobin levels , Iron stores, better neurodevelopmental outcome(T)
3 .Less need for transfusion after birth
4 .Less necrotizing enterocolitis
• Cons
Slightly increased level of bilirubin associated with more need of phototherapy

24. NORMAL TEMPERATURE OF NEWBORN IN THE
DELIVERY ROOM

25. INTERVENTION TO MAINTAIN NORMAL
TEMPERATURE

26. WARMING OF UNINTENTIONALLY HYPOTHERMIC NEWBORNS

27. MAINTAINING OF NORMOTHERMIA IN RESOURCE
LIMITED SETTINGS

28. CLEAR THE AIRWAY WHEN MECONIUM IS
PRESENT

29. ASSESMENT OF HEART RATE

31. ADMINISTRATION OF OXYGEN IN PRETERM
INFANTS

33. SPONTANEOUSLY BREATHING PRETERM
INFANTS WITH RESPIRATORY DISTRESS

36. • • Self inflating bags
• • Flow inflating bags
• • T-piece Resuscitator