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neonate life support

  1. why is resus of a newborn seen as a transition rather than a resus?
    • fluid filled lungs transitioning to air filled 
    • placenta controlling respiration ceasing and newborn begins to breathe for them self
    • childbirth is a hypoxic process
  2. what happens in utero hypoxia?
    • resp centre depresses causing spontaneous breathing to cease 
    • fetal circulation is maintained for a period of time 
    • provided circulation remains intact, respiratory centre can recover, allowing spontaneous breathing to resume
  3. what factors may affect resus of a baby at birth?
    • small 
    • wet 
    • lungs full of fluid
  4. what is the process of resus?
    • ensure warn environment 
    • dry and cover the baby- put a hat on the baby 
    • assess the baby 
    • airway 
    • breathing- inflation breathes to expand lungs prior to chest compressions 
    • circulation
  5. why should you delay the cord clamping?
    allows transfusion of blood from placenta to the baby
  6. how long should you wait before clamping the cord in a term baby?
    • at least one minute 
    • or until the cord stops pulsating
  7. how long should you wait before clamping the cord in a preterm baby?
    • at least 1 minute 
    • up to 3 minutes
  8. what may delayed clamping of the cord assist in?
    • baby's blood pressure 
    • reduce the risk of intraventricular haemorrhage
  9. what should the initial assessment of the baby involve?
    • colour 
    • tone 
    • breathing 
    • heart rate
  10. If the assessment findings were:
    Blue to pink 
    good tone
    breathing regularly 
    fast heart rate 

    What would you do?
    • dry and cover 
    • give to mum
  11. If the assessment findings were:
    moderate tone
    breathing inadequately 
    slow heart rate 

    What would you do?
    • dry and cover 
    • open the airways 
    • inflation breaths
  12. If the assessment findings were:
    Blue or white
    floppy
    not breathing 
    slow or very slow heart rate 

    What would you do?
    • dry and cover 
    • open the airways 
    • inflation breaths 
    • re-assess
    • get help
  13. for airway, what position should the head be in?
    neutral position
  14. what is a baby's occiput?
    • disproportionately large to its body 
    • consider using an object under the shoulders for neutral position
  15. what should be used to insert an OP?
    tongue depressor
  16. what should the breathing mask not cover?
    the eyes or overhang the chin
  17. what may pressure on the eyes from the breathing mask do?
    cause reflex bradycardia
  18. how should the breathing mask be put on?
    roll the mask on from chin to nose
  19. what should you do if the baby is gasping or not breathing?
    • give 5 inflation breaths- then reassess 
    • breaths delivered over 2-3 seconds 
    • helps prevent alveolar collapse 
    • repeat cycle until chest wall rise is seen
  20. what should you have done the 5 inflation breaths and seen chest rise on at least one inflation breath?
    • 30 seconds of ventilation breaths commencing on air 
    • 1 sec inspiration 
    • 1 sec expiration 
    • after 30 secs reassess the heart rate and chest wall movement
  21. when should you start chest compressions?
    • once lungs are inflated 
    • but heart rate <60
  22. how are the ventilations delivered when doing the chest compressions?
    • over 1 second 
    • introduce supplementary o2
  23. what is the ratio for chest compressions?
    3:1
  24. how long should you continue chest compressions for?
    30 seconds then re assess
  25. what speed and depth should you do the chest compressions?
    • 1/3rd depth 
    • 120 per minute= 3 compressions per second
  26. what temp should a new born be?
    36.5-37.5
  27. what happens if there is no output at 10 minutes?
    • outcome is predicted as poor 
    • rapid transport to hospital
  28. S1- you have not inflated the lungs and the baby is not breathing
    • administer a further set of 5 inflation breaths 
    • change airway position or use two person jaw thrust
  29. s2- you have inflated the lungs but the baby is not breathing, heart rate >100
    ventilate at 30 breaths per minute until the baby is breathing well
  30. S3- if you have inflated the lungs but there is a slow heart rate
    administer 30 seconds of ventilation breaths
  31. s4- if you have inflated the lungs and delivered 30 secs of ventilation breaths but the heart rate remains slow
    consider chest compressions
  32. if a baby born before 20weeks shows transient signs of life (odd gasp or movement), should you resus?
    no resus
  33. what should you do if you attend a birth between 20-23 weeks plus 6 days and there are no signs of life?
    • manage preg remains/fetal tissue
    • transfer mother and baby to maternity unit 
    • pre alert 
    • normal driving conditions
  34. what should you do when attending a birth 20-24 weeks or gestation is unknown and there are signs of life?
    • ventilate- smallest paed mask 
    • effective ventilations-baby lay flat 
    • assess HR 
    • chest will not move at this gestation- if vent effective HR will remain stable or improve 
    • keep warn- blizzard crib- hat 
    • take to ED with maternity
Author
davidgoddard93
ID
346973
Card Set
neonate life support
Description
neonate life support
Updated

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