CHAPTER 180 Neonatal Resuscitation
The first few moments of a newborn’s life can be the most critical. If needed, effective emergency care during this transition can prevent lifelong consequences. Proper resuscitation requires essential equipment and knowledge of necessary protocols before delivery. Prior knowledge of the gestational age of the newborn is helpful in anticipating the need for resuscitation. Low birth weight and premature delivery predispose infants to the need for resuscitative efforts.
As with all medical procedures, universal precautions against exposure to blood and other body fluids should be followed during this procedure. Initial measures, including proper positioning, drying, suctioning, and stimulation, should be provided to all newborns. Figure 180-2 is a flow diagram of the protocol for neonatal resuscitation that is explained in the following sections.
As with all resuscitations, the order of importance is airway, breathing, and circulation. The three cardinal indicators in neonatal resuscitation are respirations, heart rate, and color. In general, the initial assessment should take no more than 30 seconds; should the need for further resuscitation occur, reassessment of interventions should occur every 30 seconds. Apgar scores should be determined and recorded at appropriate intervals. Special circumstances may arise and may be treated with procedures used in general pediatric resuscitation (e.g., chest tube for pneumothorax).