How do you determine proper tube size?
- Below 28 weeks, below 1,000 g = 2.5 mm
- 28-34 weeks, 1,000-2,000 = 3.0 mm
- 34-38 weeks, 2,000-3,000 = 3.5 mm
- Above 38, above 3,000 = 3.5-4.0mm
What are the proper sizes for laryngoscope blades?
- No. 0 for preterm newborns
- No. 1 for term newborns
How do we determine length of ETT tube?
- <1 kg = 6 cm
- 1 kg = 7 cm
- 2 kg = 8 cm
- 3 kg = 9 cm
- 4 kg = 10 cm
How often is APGAR score assessed?
1 minute of life, 5 minutes of age, and every 5 minutes there after
What is a perfect APGAR score?
What is excellent APGAR score?
What is fair APGAR score?
What is a poor APGAR score?
What are abnormal APGAR scores directly linked to?
the degree of and the time of severe anoxia
How do we determine APGAR score?
- Heart rate: absent=0, below 100 bpm=1, above 100 bpm=2
- Respiratory effort: absent=0, weak irregular or gasping=1, good or crying=2
- Muscle tone: Flaccid=0, some flexion of arms and legs=1, well flexed, or active movements of extremities=2
- Reflex/Irritability: No response=0, grimace or weak cry=1, good cry=2
- Color: blue all over or pale=0, body pink hands and feet blue=1, pink all over=2
What is Parturition?
- Parturition is the process of giving birth and consists of
- Rupture of the membranes
- Dilation of the cervix
- Contraction of the uterus
- Separation of the placenta
- Shrinking of the uterus
How many stages of labor are there?
4, but 3 main that we worry about, and labor is actually one continuous event
What is stage 1 of labor and delivery?
Onset of regular contractions to complete dilatation of the cervix.
How long will stage 1 usually last?
What factors influence the duration of ALL stages?
- Multigravida vs. Primigravida
What is stage 2 of labor and delivery?
- Full dilatation and effacement of the cervix to delivery of the fetus
- Dilatation is the widening of the cervical opening. A 10 cm diameter cervical opening is considered fully dilated.
- Effacement is the stretching and thinning of the cervix. 100% effacement is when the cervix is not distinguishable from the uterus
How long does stage 2 of labor and delivery last?
20 min to 1-2 hours
What is stage 3 of labor and delivery?
- Delivery of the fetus to delivery of the placenta
- The fetus is in the head down position is the most common presentation. (Vertex position)
- There is also a fourth stage (not considered a major stage) where the uterus begins to shrink back to normal
How long does stage 3 of labor and delivery last?
Lasts 3-4 minutes up to 45 minutes
What is the most common process and presentation of the fetus?
- As the fetus begins down the birth canal, the head turns to a face down position for passage through the pelvis.
- Upon delivery of the head, the fetus rotates internally to ease passage of the shoulders through the pelvis.
- The upper shoulder delivers first, followed by the lower shoulder.
- After delivery of the shoulders, the rest of the body exits rather quickly.
- The umbilical cord is clamped and the baby begins life outside the uterus
What is the Breech presentation?
- The most common of all abnormal presentations (3-5% of all births).
- Three varieties:
- - Complete breech. Feet , legs, and buttocks present together.
- - Incomplete or footling breech. One or both feet descend into the birth canal first.
- - Frank breech. The legs are flexed against the body with the feet near the face with the buttocks being the presenting part.
What is Face Presentation?
Abnormal fetal presentation: The head enters the birth canal so the sutures cannot override each other and the head must pass at its full size
What is Transverse lie?
Abnormal fetal presentation: The fetus is positioned perpendicular to the birth canal with the back or back shoulders being presented
What is Prolapse of umbilical cord?
Abnormal fetal presentation: Prolapse is when the umbilical cord passes through the birth canal ahead of a body part crimping the cord
What is Occult compression?
Abnormal fetal presentation: When the cord is compressed between the fetus and the wall of the birth canal
What is Nuchal cord
Abnormal fetal presentation: Where the umbilical cord wraps around the fetus's neck
What is placenta previa?
fetus implantation blocking cervix
What is low implantation placenta previa?
Placenta implants low near cervix instead of fundus
What is partial placenta previa?
Placenta partially blocks cervix
What is total placenta previa?
Placenta completely blocks cervix
What is Abruptio Placentae?
- Premature separation from the uterine wall.
- May be partial or complete separation
- There is always hemorrhage associated with abruptio placentae
- - Vaginal bleeding may or may not be visible.
- - External hemorrhage. Visible bleeding.
- - Concealed hemorrhage. No visible bleeding