1. Prana Pratyagamana
(Resuscitation)
DR. SABIR ALI
ASSISTANT PROF.
KAMCH UDAIPUR

2. Indicate
जरायुणा मुखेच्छन्ने कण्ठे च कफवेष्टिते ।। वायोमाार्ाष्टिरोधाच्च ि र्र्ास्थः प्ररोष्टतष्टत ।(S.S.Sa. 2/54)
Obstruction of oral cavity with Jarayu (Mucous and foetal membranes)
Obstruction of Vayumarga (Respiratory tract at various levels)
Accumulation of amniotic fluid in throat
Kleshitha (Stress and strain after delivery)
तस्यास्तुखल्वपरायाः प्रपतिाथे कमाष्टण ष्टियमाणे जातमात्रस्यैव क
ु मारस्य कायाा्ेताष्टि कमााष्टण र्वन्ति, तद्यथा-
अश्मिोः सङ्घट्टिं कणायोममाले, शीतोतक
े िोष्णोतक
े ि वा मुखपररषेकः तथा सक्लेशष्टवहताि् प्राणाि् पुिलार्ेत ।
क
ृ ष्णकपाष्टलकाशमपेण चैिमष्टर्ष्टिष्पणीयुयाद्यचेिः स्यात् यावात् प्राणािां प्रत्यागार्मिम् ततः प्रत्यागार्त- प्राणं
प्रक
ृ ष्टतर्मतमष्टर्समीक्ष्य स्नािोतकग्रहणाभ्यामुपपातयेत्॥ (च. शा. 8 / 42 )
दो पत्थरोों से कर्ण क
े पास ध्वनि उत्पन्न करिा ।
शीत या उष्ण जल से मुख पर नसोंचि
क
ृ ष्णकपानलका निनमणत सूप से वायु प्रवानित करिा, जब तकनक श्वास-प्रश्वास आनद चेष्टाएँ पुिः उत्पन्न ि िो जाए।

3.  जातमात्रं ष्टवशोध्योल्बाद्वालं सैन्धवसष्टपाषा ।प्रसमष्टतक्लेष्टशतं चािु बलातैलेि सेचयेत् ॥
अश्मिोवाातिं चास्य कणाममले समाचरेत्। अथास्य तष्टिणे कणे मन्त्रमुच्चारयेष्टतमम् ॥ (अ.हृ.
उ.1/1-2 )
 लिण
 अनत प्रबल मोि तथा ज्वर से पीनित िोिा क्लेश क
े अिुरूप रोदि में असमथण िोिा
 शरीर क
े धातुओों का अस्थथर िोिा यौवि आनद अवथथाओों का अिुभव ि िोिा िस्त वस्त्रानद क
े स्पशण
का आरीवत अिुभव
 अङ्ोों को इधर-उधर फ
ें किा
 मृत्यु सदृश कष्ट का अिुभव िोिा
 ष्टचष्टकत्सा
 बलातैल पररषेक
 कर्णमूल क
े पास पत्थरोों से ध्वनि उत्पन्न करिा
 क
ृ ष्णकपानलका शूपण से िवा करिा
 दनिर् कर्णमूल क
े पास मोंत्रोच्चारर्

4. अश्मिोः सङ्घट्टिं कणायोममाले
 Ears are the most developed sensory organ in a new-born, which is completed as early as 5 months
of gestation. The sound waves produced by
Striking of stones near ears travel down the
Vestibulocochlear nerve, through intermediate stations such as
Cochlear nuclei and superior olivary complex situated in brainstem.
The respiratory centres in brain are situated at the brain stem (Medulla and Pons).
The brainstem controls several important functions such as Alertness,
Breathing, Blood Pressure, Heart rate,
Digestion and other autonomic functions. Hence by auditory stimulus there will be simultaneous activation of other
centres present in the brainstem like respiratory

5. वा मुखपररषेकः तथा सक्लेशष्टवहताि् प्राणाि् पुिलार्ेत
 The rostral portion of the ventral reticular nucleus has been shown to mediate
inspiration along with a portion of the lateral reticular nucleus.
Cold &Hot water is sprinkled,
Immediate cutaneous stimulation,
Stimulates in the autonomic nervous system,
Triggers BP (blood Pressure), by way of sudden vasoconstriction of the vessels,
क
ृ ष्णकपाष्टलकाशमपेण चैिमष्टर्ष्टिष्पणीयुयाद्यचेिः
This procedure in Prana Pratyagamana enhances the amount of oxygen saturation in the
atmosphere which helps in regaining the consciousness of the child.
The above said explanations could be the scientific reasons behind the logic of Acharya
Charaka's explanation of performing the procedures of Prana Pratyagamana

6.  Risk factors
 1. Antepartum haemorrhage
 3. Cord prolapse
 4. Placental insufficiency
 6. Premature onset of labor
 7. Prolonged labour
 8. Meconium stained liquor
 9. Foetal distress
 10. Preterm delivery
Phases of Resuscitation:
A resuscitation process can be successful only when the birth attender follows
specific guidelines, such that he /she should
• Be in anticipation of resuscitation for every delivery
• Be prepared with necessary equipments
• Know what to do, in which order and be able to work swiftly in co-ordination
with other birth attendants or helpers

7. 2 Preparation for Birth
 Preparation includes: Setting up a proper place for birth and resuscitation,
checking the functionality of the equipment and their cleanliness.

 Place for birth
 Draught free, warm room with temperature >25°C - For warm environment,
switch on radiant warmer or overhead lamp at least half hour before
anticipated time of delivery Close the windows and switch off fan to prevent
drafts of air.
 Clean, dry and warm delivery surface

8. Equipments:
 Radiant warmer or an overhead lamp with 200 watts bulb if available for
providing warmth
 Two clean & warm towels/clothes
 Folded piece of cloth (1/2 to 1" thick)
 Newborn size self-inflating bag (Ambu bag)
 Infant masks in two sizes: size '1' for normal weight baby and '0' for small baby
 Suction device
 Oxygen cylinders
 'Clock (with seconds hand)
 [Laryngoscope with straight blades of '0' and '1' size
 Endotracheal tubes óf 2 and 2.5 f
 Naso-gastric tubes (infant feeding tube)

9. Steps of Resuscitation
Methodology:
Basics of resuscitation
 The T-ABC's of pediatric resuscitation includes:
 > Temperature
 - Dry immediately
 - Provide warmth
 The newborn babies are wet after birth and heat loss is rapid in them. So it is of prime
importance that the body temperature is maintained during resuscitation.
 > Airway
 - Position
 - Clear, if required
 Ensure the airway (oral cavity) is open and should be cleared if required, for which the baby
may be placed on a flat surface with neck slightly extended.
 Breathing
 - Stimulate
 Assess whether the baby has started spontaneous breathing and if not stimulate the baby by
rubbing its back and flicking the soles
 • Circulation
 - Assess heart rate
 Assess heart rate and colour of the baby to know the adequacy of oxygenated blood
circulation. Resuscitation is to be considered at various stages if the baby is not found stable

10. Apgar Scoring
Total score Condition of the baby
0-4 Very bad
5-7 bad
8-10 Good

12.  https://youtu.be/eypOSaSRVQk

13. Thank You