Neonatal Resuscitation

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.





Technique


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.




Positioning, Suction, and Stimulation





3 Clear the airway by suctioning the mouth, then the nose, with a bulb syringe or mechanical device (suction catheter; see Chapter 178, Delee Suctioning). If mechanical suction is used, pressure should not exceed 100 mm Hg. Deep suctioning of the oropharynx may produce a vagal response and cause bradycardia and apnea. Infants with meconium-stained amniotic fluid should no longer be suctioned with mechanical devices after the head is delivered and prior to the body being delivered. Direct tracheal suctioning should be carried out only if the newborn has absent or depressed respirations, a heart rate below 100 bpm, or poor muscle tone. A meconium aspirator is very helpful in performing this procedure (see Fig. 180-1). This unique piece of equipment is used only for neonates. One end of the device is for a neonatal endotracheal tube, the other end is for suction, and the top hole is for the operator’s thumb.



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May 14, 2017 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Neonatal Resuscitation

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